Hi all, haven't been able to find much info related specifically to bottom surgery even though I'd imagine it's a relatively common complication.

I had penile inversion vaginoplasty about 7 weeks ago. Everything is healing relatively well but for the last three weeks I've had an anal fissure. It took me about a week to realise it probably wasn't hemorrhoids and to start using a topical nitroglycerine recommended by a pharmacist (I couldn't get out of the house with the pain so my gf went to ask for me), about another week to get a home doctor to check and confirm, basically recommending I continue with the ointment and adding a hemorrhoid suppository to help with healing/lubrication, as well as stool softeners and to continue with fibre supplements + increased fluids. It's been another week since then and while the pain hasn't been quite as bad, the blood after bowel movements seems worse and I was only able to make it to two of my four shifts for my first week back at work which is really frustrating.

Just wanted to see if anyone had any further insights or recommendations. I was using sitz baths to try promoting healing but the doctor said it's probably not significantly helpful and it does take a lot out of my day, while putting pressure on the area too. It can hurt back there when I dilate so I'm not really able to as much as I'd like either. I'm a bit worried that maybe my surgeon has pulled everything up inside a bit too tight, as we didn't use any skin grafts for my surgery due to me having sufficient tissue and not being too fussed with depth (uncircumcised, young, only been on t blockers 2.5 years, no orchiectomy before surgery and wasn't particularly small beforehand). Is this a thing that can happen? I have a phone consult with him in a little over a week. I just really don't want this to turn into a chronic issue and I'm going a bit crazy from finally recovering in one area, only for another issue to arise. I'm also worried I'll have to have surgery to alleviate the fissure and I don't think I can go through another procedure right now.

Update: It finally healed after sticking to a routine of using the GTN ointment 3-4 times a day, lubricating suppository twice a day, using a bidet/wet wipes instead of wiping, a poop stool, stool softeners before bed, and dropping the fiber supplements which I suspect were actually bulking my stool too much. I also used a technique that I think helped a lot more than I thought it would where you basically hold the tear together while going to the toilet with a gloved hand by gently pushing up on it through the whole movement. Safe to say I am so relieved and going back to work has been a lot easier.