Randomized clinical trial comparing botulinum toxin injections with 0·2 per cent nitroglycerin ointment for chronic anal fissure

Authors: Brisinda, G.; Cadeddu, F.; Brandara, F.; Marniga, G.; Maria, G.

Source: British Journal of Surgery, Volume 94, Number 2, February 2007 , pp. 162-167(6)

Buy & download fulltext article:

The full text article is not available for purchase.

The publisher only permits individual articles to be downloaded by subscribers.

Abstract:

Background:

In recent years treatment of chronic anal fissure has shifted from surgical to medical. This study compared the ability of two non-surgical treatments—botulinum toxin injections and nitroglycerin ointment—to induce healing in patients with idiopathic anal fissure.

Methods:

One hundred adults were assigned randomly to receive treatment with either type A botulinum toxin (30 units Botox^® or 90 units Dysport^®) injected into the internal anal sphincter or 0·2 per cent nitroglycerin ointment applied three times daily for 8 weeks.

Results:

After 2 months, the fissures were healed in 46 (92 per cent) of 50 patients in the botulinum toxin group and in 35 (70 per cent) of 50 in the nitroglycerin group (P = 0·009). Three patients in the botulinum toxin group and 17 in the nitroglycerin group reported adverse effects (P < 0·001). Those treated with botulinum toxin had mild incontinence to flatus that lasted 3 weeks after treatment but disappeared spontaneously, whereas nitroglycerin treatment was associated with transient, moderate-to-severe headaches. Nineteen patients who did not have a response to the assigned treatment crossed over to the other therapy.

Conclusion:

Although treatment with either topical nitroglycerin or botulinum toxin is effective as an alternative to surgery for patients with chronic anal fissure, botulinum toxin is the more effective option. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

Document Type: Miscellaneous

DOI: http://dx.doi.org/10.1002/bjs.5514

Publication date: 2007-02-01

More about this publication?

As of January 2010, this journal will no longer be available on IngentaConnect, please visit Wiley InterScience to arrange continued access to this content
Access this journal at Wiley InterScience
ingentaconnect is not responsible for the content or availability of external websites

Randomized clinical trial comparing botulinum toxin injections with 0·2 per cent nitroglycerin ointment for chronic anal fissure

Buy & download fulltext article:

Tools

Key

Text size:

Useful pages