Using FMS dilators for anal fissures

General information about anal fissures can be found in our Anal Fissure guide.

Details about the unique properties behind the exceptional effectiveness of FMS dilators are explained in Special Features of FMS Dilators.

Using dilators – often called “anal stretchers” or “spreading rods” – for fissures might seem counterintuitive at first: "Stretching something that’s torn?" Of course not. FMS dilators are completely different from cone-shaped silicone dilators. Thanks to their special shape and frictionless material, they’re also suitable for treating fissures. Their effect is not primarily based on stretching but on gently mobilising and (re-)activating rigid, cramped areas.

For treating fissures, you’ll definitely need a full dilator set – ideally one with the smallest possible size increments (1–2 mm), because it’s essential to proceed with great care. Choosing the right starting size is also crucial: if the dilator is too small, it will have little effect; if it’s too large, it won’t be usable. We’ll guide you in finding the right set and the best starting size for your needs.

Dilator use for anal fissures is based on three key functions:

• Releasing tension (in cases of muscular spasm)
• Stimulating / massaging (to support healing)
• Flexibilising and strengthening (for long-term prevention)

Releasing anal muscle spasms

Anal fissures are often caused by chronic tension in the sphincter muscle – in some cases even leading to a full-blown spasm. Psychological causes of this tension should always be addressed separately. On the physical level, it’s best not to begin dilator use immediately after the fissure appears, as the acute phase can make treatment more difficult. However, in cases of severe spasms, treatment might still be necessary despite the fissure.

To begin, it’s essential to use a dilator size that you can insert without discomfort – as far as possible. That’s why FMS dilators are available from just 14 mm and made of glass, which is extremely smooth and makes insertion much easier.

1) First, cover the fissure with a protective ointment – ideally one with a firmer consistency.

2) Warm up the glass dilator: heat helps relax muscle spasms. For fresh fissures, wait a day or two if possible. If that’s not an option due to acute cramping, warm the dilator to body temperature in a water bath. Warm the lubricant too. We recommend hypoallergenic pjur med gel.

3) Dry the dilator so the lubricant doesn’t get diluted. Apply a little lube to the dilator, your anal opening, and gently over the fissure. If possible, also insert a small amount of lube into the rectum to keep things smooth.

4) Now insert the dilator using gentle, alternating pressure. If your sphincter doesn’t open without pain, switch to a smaller size.

5) Once inserted, take a few minutes to relax.

6) Slowly begin to move the dilator back and forth. Gradually increase this motion.

7) Then fully remove the dilator and reinsert it immediately. Repeat this in-and-out motion – start slowly and gradually build up the rhythm. This creates a gentle, pulsating stimulation of the sphincter muscle that helps release the tension. You can focus just on moving the tip of the dilator in and out.

8) To enhance the effect, you can repeat the treatment with the next size up – but only if it’s pain-free given your condition. At this stage, the goal is stimulation, not stretching or size progression. If you move up in size too quickly, you risk reopening the fissure instead of helping it heal.

Stimulating through massage

Gentle, regular use of the dilator boosts cell metabolism and blood circulation, which supports wound healing. At this stage, your goal should not be to stretch or increase sizes, but rather to focus on consistent, careful stimulation of the sphincter and the entire rectal area.

Improving Flexibility

As healing progresses, and after longer periods of regular massage, you can gradually move up to larger sizes to increase the sphincter’s flexibility. This ensures lasting success in your treatment.

When removing the dilator from your body, try to “grip” the tip of the dilator with your sphincter muscle and hold it. This repeated alternation between relaxation (insertion) and contraction (removal) strengthens the anal sphincter as it becomes more flexible.

In addition, the muscle memory relearns the different levels of tension: relaxation – baseline tone – active contraction.

This kind of use involving contraction is only possible thanks to the unique shape of FMS dilators. You’ll find more details in the user guide.

Prevention

Once the anal fissure has fully healed, you can move on to more intensive massage as a form of prevention and increase the dilator sizes more quickly within a single session. The method of use remains the same: alternating between inserting the dilator during relaxation and trying to hold it during contraction.

We also recommend incorporating conscious breathing into your practice, following the E-A-E / I-E-I pattern:
E-A-E = exhale – activate – extract
I-E-I = inhale – ease – insert

This rhythm helps coordinate your breath with your pelvic floor activity and supports a deeper therapeutic effect.

Healing “Side Effects”

These final exercises have a highly beneficial effect on the entire pelvic floor – especially when it comes to preventing incontinence.

In men, depending on the intensity of use, these techniques can also stimulate and massage the prostate. Of course, you can also use FMS dilators as a man specifically for prostate massage – even without any symptoms – to help prevent prostatitis or erectile dysfunction and support or enhance your potency.

For Women, Trans People, and Couples

FMS dilators are equally suitable for treating various vaginal conditions, such as:

• Birth-related injuries (e.g. vaginal or perineal tears), vaginismus, incontinence
• Radiation therapy after-effects
• Pain during penetration or intercourse during menopause
• Preparing for penetration or sex after a long period of abstinence

FMS dilators are uniquely suited for aftercare and ongoing treatment following gender-affirming surgery. In addition to all their therapeutic uses, the phallic shape of the FMS dilators also allows for erotic applications as glass dildos – see “Applications for Couples” for more.

You'll find a full overview of all application possibilities under Special features of FMS dilators.

Free therapeutic advice

You'll find more information under "Frequently asked questions about FMS dilators", and our guided cover additional specialised topics. If you still have questions, feel free to email me personally. I'll be happy to help.

Contact: hsw@theros.de

Hera Schulte Westenberg