No surgery is usually necessary for anal fissures. These fissures usually result from chronic constipation
, so the first step would be to make sure you are moving your bowels regularly without straining, therefore you need to be on a regular dose of laxatives (such as miralax
) plus stool softeners (such as colace). These are over the counter.
Lubowell may help but sometimes it is not enough. Sometimes a prescription cream needs to be added to help the healing of the fissure (such a nitroglycerin
rectal cream), however you would need to be seen by a gastroenterologist or colorectal surgeon. I don't know what you mean by a tube like structure (maybe a skin tag, a polyp, a condyloma?), but you probably need to be evaluated by either of these doctors.
hope that helps