Anal fissure surgery is usually carried out when other treatments such as diltiazem cream or botulinum toxin A injections have been unsuccessful. The procedure involves your surgeon making a small cut in the ring of muscle that holds your anus closed (internal sphincter muscle) to stop it from going into spasm.n this procedure your anal fissure is removed completely, leaving an open wound to heal naturally. This surgery can be used alone, with lateral internal sphincterotomy, or with medicines such as glyceryl trinitrate or botulinum A toxin injections.
First-Class Mail International. Our most affordable international service for postcards, letters, and flats to more than 180 countries. You can also use our Global ForeverÂ® stamp to mail postcards or 1 oz letters anywhere in the world. Beginning at $1.15 at Post Officeâ¢ locations.
Letters destined for Canada and Mexico-for the (1) ounce first class letter cost $1.20 as of May 31st, 2015 that was a 5 cent hike from $1.15 effective January 26 `014 with the global forever stamp (then applying to all international destinations forward).ny extra ounce(s) are subject to a fee of $0.22 per added ounce as of May 31st, 2015 (previously $0.21 per oz). Another prior rise in rates occurred January 27, 2013 when the price of a first class letter sent through the United States Post Office went up $0.01 to $0.46.