Botulinum toxin versus other therapies for treatment of chronic anal fissure

Maria Michela Chiarello, Maria Cariati, Giuseppe Brisinda

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

Anal fissure is the most frequent of proctological pathology after hemorrhoids. The hypertonicity of the internal sphincter and the hypovascularization of the posterior pole of the anus play a central role in its pathophysiology. Treatment aims to reduce the hypertonicity of the internal sphincter, thus eliminating pain, allowing healing, and avoiding recurrence. Treatment of acute anal fissure is essentially medical; treatment of chronic anal fissure resistant to therapy is surgical. The reference surgical treatments are lateral internal sphincterotomy (LIS), regardless of its risk for flatus incontinence, and posterior sphincterotomy with anoplasty. Conservative approaches such as topical application of ointment or botulinum toxin injections have been proposed in order to treat this condition without any risk of permanent injury to the internal anal sphincter. These treatments are effective in a large number of patients. Furthermore, with the availability of medical therapies to induce healing of anal fissure, the risk of a first-line surgical approach is difficult to justify. The conservative treatments have a lower cost than surgery. This paper reports the most recent findings on conservative treatment of chronic anal fissure.
Lingua originaleEnglish
pagine (da-a)457-463
Numero di pagine7
RivistaCOLO-PROCTOLOGY
Volume42
DOI
Stato di pubblicazionePubblicato - 2020

Keywords

  • Conservative treatment
  • Fecal incontinence
  • Lateral internal sphincterotomy
  • Nitrates
  • Surgical procedures, operative

Fingerprint

Entra nei temi di ricerca di 'Botulinum toxin versus other therapies for treatment of chronic anal fissure'. Insieme formano una fingerprint unica.

Cita questo