Comparative outcomes of Botulinum toxin and sphincterotomy in treatment of chronic anal fissure

Abstract Background: Chronic anal fissure is a tear in the lower half of anal canal usually in midline posterior. It is accompanied by pain and bleeding. In chronic cases sphincterotomy operation is suggested. Objective: To compare the surgical results of sphincterotomy and botulinum toxin in treatment of chronic anal fissure. Methods: This prospective study was implemented on 40 women suffering from chronic posterior anal fissure who had referred to either Shahid Rajaee’s hospital or private medical offices (2001). Being divided into 2 groups of 20, the first group were treated by injecting 25 units of botulinum toxin and sphincterotomy operation was preformed on the second group. Using Fisher-P statistical tests, the data was analyzed. Findings: Patients were followed up for two months. 13 patients of the first group & 19 patients of the second one were completely cured. Conclusion: Having no complication, needing no hospitalization and being cheap, botulinum toxin can be used as an alternative to sphincterotomy in treatment of chronic anal fissure.