Botulinum toxin for recurrent anal fissure following lateral internal sphincterotomy

Abstract

Botulinum toxin is efficacious in patients with recurrent anal fissure following lateral internal sphincterotomy.

Fissurectomy combined with anoplasty and injection of botulinum toxin in treatment of anterior chronic anal fissure with hypertonia of internal anal sphincter: a pilot study

“…The fissurectomy associated with reversible chemical sphincterotomy was first introduced in 2002 [34]. Among the drugs most commonly used for the pharmacological sphincterotomy, the botulinum toxin is better tolerated by patients due to high compliance associated with a low incidence of related side effects [35]. The botulinum toxin injection associated with the fissurectomy for the treatment of CAF has been reported by other authors [23,[36][37][38] with a high success rate and low morbidity.…”

“…Each patient received a total of 30 UI of botulinum toxin equally divided on either side of the posterior midline. According to others [10], we always performed a Botox injection posteriorly because the site of injection depends on the location of the fissure and it should be anterior for posterior fissure and posterior for anterior ones [10]. None of the patients assumed concomitant oral medications that could interfere with the action of type A botulinum toxin (aminoglycosides, baclofen, dantrolene, diazepam) and there was no known hypersensitivity to any component of botulinum toxin formulation.…”

Advancement flap in the management of chronic anal fissure: a prospective study

“…Each patient received a total of 30 UI of botulinum toxin equally divided on either side of the midline. According to others, the site of injection depends on the location of the fissure and it should be anterior for posterior fissure and posterior for anterior ones [9]. None of the patients assumed concomitant oral medications that could interfere with the action of type A botulinum toxin (aminoglycosides, baclofen, dantrolene, diazepam) and there was no known hypersensitivity to any component of botulinum toxin formulation.…”

Endoscopy in the Diagnosis and Management of Motility Disorders

“…The technique involves injection of 30 units of BoTox into two sites of the internal sphincter, and the dosage may vary up to 50 units in order to alter sphincter relaxation. BoTox injection may also be used in the treatment of postsphincterotomy recurrent anal fissure with *70% success rate, and re-injection may be applied if needed [95].…”