Surgical sphincterotomy for chronic anal fissure can cause fecal incontinence. This has led to the investigation of nonsurgical treatment options that avoid permanent damage to the internal anal sphincter. We conducted a retrospective, ongoing chart review with telephone follow-up of 88 patients treated for chronic anal fissure between November and December During the first half of the study period, patients were treated with topical nitroglycerin and pneumatic dilatation.
With the availability of new therapies in June fissure, subsequent patients received topical nifedipine and anal toxin injections 30— units. Lateral anal sphincterotomy was reserved for patients who failed medical treatment.
There was no statistical difference between the number of dilatations and botulinum toxin black dick picture gallery needed to achieve healing. Three patients who received botulinum toxin fissure mild transient flatus incontinence. Chronic anal fissures can be simply and effectively treated medically without the risk of incontinence associated with sphincterotomy.
Anal Fissure Symptoms, Treatment Relief, and Cure
Topical nifedipine and botulinum toxin injections are an excellent combination, associated anal a low recurrence rate and minimal side effects.
Chronic anal fissure is a common benign anorectal condition that causes significant morbidity.
Symptoms consist primarily of pain and bleeding during defecation. It is generally accepted that the chronicity of anal healing is the result of poor anodermal perfusion, especially healing the posterior commissure. Local ischemia is likely a function of elevated resting anal pressures commonly associated with fissures, acting on an area that has inherently poor vascular supply.