Hello, I have been suffering with my tail end for quite some time now. About three years ago I had a time of being very constipated and subsequently I gained an anal fissure and 2 sentinel piles at either end of my anus. I tried glycerol trinite treatment cream to no avail and so I had a sphincterotomy which healed the anal fissure. However the doctor removed one sentinel pile, and left the other which has since healed into a wodge of skin in the same shape, but not an open wound as such. However where the other pile was removed is refusing to heal and has been for about 6 months. It is quite a small wound but is very persistent, hurting quite a lot and leaving traces of blood on toilet roll. As well as this the wodge of skin as I would call it, basically a healed-over pile is becoming increasingly uncomfortable, it is big and itchy, often ruining my hygiene. My doctor says he wants to wait for the open wound to heal as he hopes it eventually will, but I don't understand why it has not done this already. I have modified my diet over the past year to very high fibre and have regular soft bowel movements and wipe with baby wipes. I take baths most nights to stay clean but it just won't heal. What should be the next course of action? Would some sort of stitch work, or another operation? And will a doctor remove the lump of excess skin which is incredibly annoying? I know there will be a subsequent wound but I feel like I need to move on and retain a normal rear end. Do you have any suggestions? I am seeing my doctor in a week to discuss things. I'm very worried, please help.