Abstract | PURPOSE: METHODS: A prospective, nonrandomized, open-label study of patients with chronic anal fissure failing a course of glyceryl trinitrate treated with 20 units of botulinum toxin A injected into the internal sphincter was conducted. Symptomatic relief, visual healing of fissures, side effects, and patient preference were assessed at 8-week follow-up. RESULTS: Forty patients underwent botulinum toxin treatment. Twenty-nine patients (73 percent) overall were improved symptomatically and avoided surgery. Seventeen fissures (43 percent) were healed, whereas 23 fissures (57 percent) remained unhealed. Of the unhealed fissures, 5 (12 percent) were asymptomatic, 7 (18 percent) were symptomatically much improved, and 11 (27 percent) were no better symptomatically and came to surgery. Discomfort associated with injection was minimal. Of 34 patients undergoing botulinum toxin injection in the clinic, 24 (71 percent) preferred botulinum toxin, 7 glyceryl trinitrate (20 percent; difference = 51 percent; 95 percent confidence interval = 31-71 percent), and 9 percent were undecided. Transient minor incontinence symptoms were noted in 7 patients (18 percent). CONCLUSIONS:
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Authors | Ian Lindsey, Oliver M Jones, Chris Cunningham, Bruce D George, Neil J M Mortensen |
Journal | Diseases of the colon and rectum
(Dis Colon Rectum)
Vol. 46
Issue 3
Pg. 361-6
(Mar 2003)
ISSN: 0012-3706 [Print] United States |
PMID | 12626912
(Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Vasodilator Agents
- Botulinum Toxins
- Nitroglycerin
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Anal Canal
- Botulinum Toxins
(administration & dosage, adverse effects, therapeutic use)
- Chronic Disease
- Female
- Fissure in Ano
(drug therapy)
- Humans
- Male
- Middle Aged
- Nitroglycerin
(therapeutic use)
- Patient Satisfaction
- Prospective Studies
- Treatment Failure
- Treatment Outcome
- Vasodilator Agents
(therapeutic use)
- Wound Healing
(drug effects)
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