A New Botox Therapy Method in Chronic Anal Fissüre

Abstract

BackgroundBotox toxin treatment(BT) is an effective method in chronic anal fissures(CAF).However, there are different suggestions regarding the application place and method of BT in the literature. Our aim in this study is to reveal the most appropriate application site and method in BT for CAFs. MethodsFor this purpose, 2 groups were randomly selected from patients who admitted to our hospital with CAF complaints. In our study, we performed the BT application in different places in different amounts in both groups. After the treatment, we evaluated the recurrence and anal incontinence scores of the patients in certain periods and compared them with each other. The follow-up period for our patients were at least 12 months. ResultsThe recurrence rate was found to be 33.3% in patients in Group A (Gp A) and 19.3% in patients in Group B (Gp B). Patients in Gp A had a statistically significant higher recurrence rate (inadequate treatment) compared to patients in Gp B at the first control, which was performed at first week after treatment(p<00.5). Anal incontinence rate 3.3% in Gp A, 6.4% in Gp B. The difference between anal incontinence rates according to Cleveland Clinic Incontinence Score (CCIS) was not statistically significant between patients with GP A and Gp B (p>0.05).Conclusion3-way BT in internal and external anal sphincters in CAFs, is an effective and low-risk treatment method.