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Nitroglycerin, Botox or Sphincterotomy for Anal Fissure

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This document discusses different treatment options for anal fissures, including sphincterotomy, glyceryl trinitrate (GTN), and botulinum toxin (Botox) injections. Sphincterotomy has the highest healing rates of 90-95% but carries a small risk of incontinence. GTN provides pain relief through its effects on the internal anal sphincter but has lower healing rates than sphincterotomy. Botox injections help relax the sphincter like GTN but have significantly lower healing rates and higher failure rates requiring reoperation compared to sphincterotomy. The best approach depends on the individual patient's history, symptoms, and preferences regarding risks and benefits of each option

Health & Medicine
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Nitroglycerin, Botox or Sphincterotomy for Anal Fissure ,[object Object],[object Object],[object Object]
Aetiology ? Trauma Sphincter spasm Ischaemia
Typical Anal Fissure
Treatment ,[object Object],[object Object],[object Object]
How to relieve spasm? ,[object Object],[object Object],[object Object]
Botox ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
GTN ,[object Object],[object Object],[object Object],[object Object],[object Object]
Sphincterotomy ,[object Object],[object Object],[object Object],[object Object],[object Object]
Sphincterotomy Define the IAS Open or Closed? Tailored? Debride the fissure?
Adelaide study 1 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Adelaide study 2 ,[object Object],[object Object],[object Object],[object Object],[object Object]
Adelaide study 3 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Literature ,[object Object],[object Object],[object Object],[object Object]
Management Considerations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Primary Fissure What I do ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Recurrent Fissure after sphincterotomy ,[object Object],[object Object],[object Object],[object Object]
Other Alternatives? ,[object Object],[object Object],[object Object]
Incontinence Post Sphincterotomy ,[object Object],[object Object],[object Object],[object Object],[object Object]
Summary ,[object Object],[object Object],[object Object]
Conclusions ,[object Object],[object Object],[object Object]

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