Botulinum toxin to promote healing and relieve symptoms of chronic anal fissure : a report of 65 cases

Abstract EN

Background: : Benign anorectal diseases are common, and, of these, chronic anal fissure has been one of the most difficult to treat satisfactorily.

Lateral internal sphincterotomy, the most common treatment for chronic anal fissure, may cause permanent injury to the anal sphincter.

Botulinum toxin has been used to effectively relieve spasm of the anal sphincter and promote healing.

Purpuse: Studying the effectiveness of this new method of treating the chronic anal fissure.

Methods :: In this series, we have followed 65 patients with chronic anal fissures for 2 1/2 years.

These patients had not responded to medical therapy for more than 2 months.

They were given botulinum toxin by injection into the fissure.

Results: On follow up, 60 patients (92%) had complete resolution of symptoms with healing of the fissure.

Five patients (8%) continued to have symptoms and subsequently underwent surgery.

Two patients (3%) had recurrence after healing.

Both were treated with a second injection with long lasting resolution.

Conclusion : Treatment with botulinum toxin is effective as an alternative to surgery for patients with chronic anal fissure.