![]() Randomised trial of topical 0,2% glyceryl trinitrate and lateral internal sphincterotomy for the treatment of patients with chronic anal fissure: long-term follow-up. Long term results of topical nitroglycerin in the treatmet of chronic anal fissures are disappointing. Topical 0.2% glyceryl trinitrate ointment for anal fissures: long-term efficacy in routine clinical practice. Follow-up of patients with chronic anal fissure treated with topical glyceril trinitrate. Systemic levels of glyceryl trinitrate following topical application to the anoderm do not correlate with the measured reduction in anal pressure. Jonas M, Barrett DA, Shaw PN, Scholefield JH. lateral internal sphincterotomy for chronic anal fissure: a prospective, randomized, controlled trial. Clinical, manometric, and ultrasonographic results of pneumatic balloon dilatation vs. The epidemiology and treatment of anal fissures in a population-based cohort. ![]() Anterior anal fissures are associated with occult sphincter injury and abnormal sphincter function. An evidence-based algotithm for anal fissure. Lund J, Nyström P-O, Herold A, Schouten WR, Arroyo A, Pescatori M. ![]() Sustained internal sphincter hypertonia in patients with chronic anal fissure. Keywordsįarouk R, Duthie G, MacGregor AB, Bartolo DCC. A chance of postoperative incontinence is the main reason why drug treatment is now considered as the first therapeutic option, especially in patients with a high risk for incontinence. Sphincterotomy is an outpatient procedure with a success rate greater than 90 %, but it has a postoperative incontinence rate between 3 % and 15 %. If these treatments fail, surgery is the best option. The results of these treatments are better than placebo but inferior to surgery. Pharmacological treatment is based on three groups: a nitric oxide donor (glyceryl trinitrate), calcium channel antagonists (diltiazem, nifedipine), and botulinum toxin. General measures consist of sitz baths, avoiding the presence of hard stools by using laxatives or significantly increasing fiber intake, and using analgesics. Treatment of anal fissure is based on general measures and pharmacological intervention. If there are multiple fissures or occur at a lateral position, other anal pathologies must be ruled out (e.g., tuberculosis, syphilis, HIV, Crohn’s disease). A fissure is usually located in the posterior (in 90 % of cases) or anterior midline (in 10 % of women and 1–5 % of men with anal fissure). It may be accompanied by minimal bleeding. Anal pain is usually intense, occurs during or minutes after a bowel movement, and can last from minutes to hours. It is accompanied by a significant increase in the tone of the internal anal sphincter. 5405: 342, 1964.An anal fissure is a tear in the epithelial lining of the anal canal, distal to the dentate line. Goligher: Stretching of anal sphincters in treatment of fissure-in-ano. London, Longmans, Green & Co., 1900, Part I, 311 pp. E.: An anorectal plastic operation for fissure and stenosis and its surgical principles. (editor): Diseases of the Colon and Anorectum. R.: Inflammations and infections of the anus. C.: Surgery of the Anus, Rectum and Colon. B.: The Principles and Practice of Rectal Surgery. Goligher: Results of internal sphincterotomy.
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