Botox® for chronic anal fissure: is it useful? A clinical experience withmid-term follow-up

Botox® for chronic anal fissure: is it useful? A clinical experience withmid-term follow-up

Authors

  • G. Piccinni
  • E. Poli
  • A. Angrisano
  • A. Sciusco, et al.

Keywords:

Anal fissure, botulinum toxin, follow-up, conservative therapy

Abstract

Background: Sphincterotomy has been the most commonly used treatment for chronic anal fissures. Although effective it is associated with incontinence (0-20%). Intrasphincteric Botulinum Toxin A injection seems to be a reliable option. The aim of this clinical report is to verify the effectiveness of this treatment in relieving symptoms and healing fissures without relapse. Methods: The study design was an open label non-comparative prospective trial to evaluate the efficacy of botulinum toxin injection in anal sphincters.  In the period 2003-2005 sixty patients were enrolled in our Unit of Coloproctology. After inoculation hygiene measures (sitz baths, Vaseline oil and water intake) were recommended. After the first 4 weeks without improvement we administered a second injection (30 U.I). After failure of the second administration the patient was addressed to surgery. Mean follow-up was 24 months; patients were re-evaluated at the 6th, 12th and 24th month. Results: In 29 pts the fissure was healed (48.33%) after the first injection; 31 patients (51.6%) were re-treated; 20 pts presented a complete healing of the fissure in a period ranging between 4-5 weeks from the second injection and 11 patients were introduced to surgery. In 3 cases we observed haemorrhoidal thrombosis. Gas incontinence was reported in two patients and solved spontaneously. Conclusions: Our clinical experience suggests that botulinum toxin therapy can be considered effective and safe. It can be proposed to the patient as first line therapy before surgery.

Downloads

Published

01-12-2009

Issue

Section

ORIGINAL ARTICLES

How to Cite

1.
Botox® for chronic anal fissure: is it useful? A clinical experience withmid-term follow-up. Acta Biomed [Internet]. 2009 Dec. 1 [cited 2024 May 29];80(3):234-7. Available from: https://mattioli1885journals.com/index.php/actabiomedica/article/view/1178