Effectiveness of higher doses of botulinum toxin to induce healing in patients with chronic anal fissures

Brisinda, Giuseppe; Maria, Giorgio; Sganga, Gabriele; Bentivoglio, Anna Rita; Albanese, Alberto; Castagneto, Marco

doi:10.1067/msy.2002.119314

Cited by 140 publications

(118 citation statements)

References 29 publications

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“…Doses have varied between 5 to 100 units of BOTOX®, with various studies suggesting a dose-dependent efficacy of BOTOX® treatment. [13] [14] Compared with placebo, injection of botulinum toxin into the internal anal sphincter has been shown to be significantly better at healing anal fissures (73%) and in symptomatic relief (87%) at 2-month follow up. [15] Various randomized prospective studies have compared botulinum toxin injection with glyceryl trinitrate for the treatment of chronic anal fissures.…”

Section: Methodsmentioning

confidence: 99%

Anal Fissure Revisited : A Systematic Review

Singh¹,

Chandrakar²,

Agrawal³

et al. 2015

jemds

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Anal fissure is one of the most common anorectal problems. Anal fissure is largely associated with high anal sphincter pressures and most treatment options are based on reducing anal pressures. There are many options to treat chronic fissures in ano. Some of them are non-surgical while the others are surgical. The efficacy claimed by each of the prevalent method is very high but the inconsistencies and contraindications are equally strong. To date, lateral sphincterotomy has been favoured by most of the proctologists, because it is the least extensive surgical procedure and is offering a long lasting relief in sphincter spasm. Various management technique are reviewed in this article along with Advancement flap for anterior fissure and a new method combining the age-old technique of Lord's manual dilatation followed by radio surgery is also highlighted along with their complications. The addition of radio surgery is found useful for refreshing the edges of the fissure and to tackle pathologies namely sentinel pile, small internal piles or hypertrophied anal papillae often found associated with chronic fissures. Revisiting the trends of treatment of chronic anal fissures, the most preferred options are the manual dilatation with radio surgery and the subcutaneous lateral anal sphincterotomy. Both methods are easy to perform, have negligible complications and no special setup is needed, except the radio surgical unit, in case of the first procedure.

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Section: Methodsmentioning

confidence: 99%

Anal Fissure Revisited : A Systematic Review

Singh¹,

Chandrakar²,

Agrawal³

et al. 2015

jemds

View full text Add to dashboard Cite

show abstract

“…It provides muscle relaxation by blocking neurotransmitter release. Moreover, it shows an analgesic effect via inhibiting neuropeptide release in nociceptors [8]. Clostridium bot- T Ta ab bl le e I I. .…”

Section: Discussionmentioning

confidence: 99%

Effect of botulinum toxin in selected chronic anal fissure patients: long-term results

Karabulut¹,

Doğan²,

Moray³

2012

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“…Botulinum-Toxin reduziert den analen Ruhedruck vorüberge-hend über 2-3 Monate [7,19,40]. Die häufigsten Nebenwirkungen liegen in einer vorübergehenden, zum Teil aber Wochen anhaltenden Inkontinenz für Winde in bis zu 10% [8,29] und festen Stuhl bis 5% [28,38]. Bis zu 20% aller Patienten sprechen auf eine Botulinum-Therapie nicht an [19,28], -mit einer erhöhten Dosis werden aber auch bei diesen Patienten Abheilungen ermöglicht [28].…”

Section: Botulinum-toxinunclassified

Fisteln und Fissuren

Heitland

2009

Coloproctol

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Effectiveness of higher doses of botulinum toxin to induce healing in patients with chronic anal fissures

Cited by 140 publications

References 29 publications

Anal Fissure Revisited : A Systematic Review

Anal Fissure Revisited : A Systematic Review

Effect of botulinum toxin in selected chronic anal fissure patients: long-term results

Fisteln und Fissuren

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