It is useful for haemostasis and holding it open for a while. This procedure is not dilatation but 'stretching' with some force and some feeling of adequacy. It is that much different and I feel it has reduced recurrence to nominal because it lasts. It is neither maximal nor inadequate but 'just enough'. It is to be practiced and perfected.
Effort is worthwhile, it covers the attention to sphincter theory in treatment of haemorrhoids.
Open or subcutaneous sphincterotomy is most likely to be inadequate as one is scared to divide a lot of sphincter. Besides it will cut all fibres - good and bad at one point damaging sphincter strength. Stretching would be a deliberate 'highly selective closed sphincterotomy', tearing out rigid fibres and saving elastic fibres which would stretch but not break. Stretching also ruptures the plexus and a haematoma is formed which is useful for sclerosis and subsequent adhesion of mucosa to muscle causing devascularisation of submucous space. Transient sphincter dysfunction due to bruising may occur but gets better with time.