Anal stretch has a higher risk of fissure persistence than internal sphincterotomy and also a significantly higher risk of minor incontinence than sphincterotomy .
The combined results of open versus closed partial lateral internal sphincterotomy show little difference between the two procedures both in fissure persistence and risk of incontinence .
AUTHORS ' CONCLUSIONS Anal stretch and posterior midline internal sphincterotomy should probably be ab and oned in the treatment of chronic anal fissure in adults .
For those patients requiring surgery for anal fissure , open and closed partial lateral internal sphincterotomy appear to be equally efficacious .
BACKGROUND Operative techniques commonly used for fissure in ano include : anal stretch , open lateral sphincterotomy , closed lateral sphincterotomy , posterior midline sphincterotomy and to a lesser extent dermal flap coverage of the fissure .
Reports of direct comparisons between operative techniques for anal fissure are variable in their results .
These reports are either subject to selection bias ( in non-r and omized studies ) or observer bias ( in all studies ) or have inadequate numbers of patients enrolled to answer the question of efficacy .
OBJECTIVES To determine the best technique for fissure surgery .
Effects of Warm Water Sitz Bath on Symptoms in Post-anal Sphincterotomy in Chronic Anal Fissure—A Randomized and Controlled Study
Background Sitz bath is frequently recommended by physicians for a variety of anal disorders including anal fissure . The aim of the present study was to determine whether sitz bath does have any therapeutic properties improving upon a patient ’s postoperative symptoms after a closed lateral sphincterotomy . Material s and Methods Forty-six patients were r and omly assigned to receive analgesics and fiber supplement alone ( control patients ) or a twice-daily sitz bath along with identical fiber and analgesics ( sitz bath group ) . A 24-h pain score — post-defecation anal burning and symptom improvement — was evaluated on a visual analog scale ( VAS ) . Results The groups were equally matched for age , gender distribution , and duration of disease . No significant difference in mean pain score between groups ( p = 0.284 ) was noticed after one week . However , the patients from the control group experienced significant anal burning compared with patients from sitz bath group ( p < 0.0001 ) . The improvement score was higher in the sitz bath group when compared with the control group ; however , it did not reached a statistically significant level . Conclusions Patients after sphincterotomy for anal fissure receiving sitz bath experienced similar levels of pain when compared with those not receiving sitz bath . However , they reported a significant relief in anal burning and a marginally better satisfaction score and no reported adverse side effects
Anal stretch has a higher risk of fissure persistence than internal sphincterotomy and also a significantly higher risk of minor incontinence than sphincterotomy .
The combined results of open versus closed partial lateral internal sphincterotomy show little difference between the two procedures both in fissure persistence and risk of incontinence .
AUTHORS ' CONCLUSIONS Anal stretch and posterior midline internal sphincterotomy should probably be ab and oned in the treatment of chronic anal fissure in adults .
For those patients requiring surgery for anal fissure , open and closed partial lateral internal sphincterotomy appear to be equally efficacious .
BACKGROUND Operative techniques commonly used for fissure in ano include : anal stretch , open lateral sphincterotomy , closed lateral sphincterotomy , posterior midline sphincterotomy and to a lesser extent dermal flap coverage of the fissure .
Reports of direct comparisons between operative techniques for anal fissure are variable in their results .
These reports are either subject to selection bias ( in non-r and omized studies ) or observer bias ( in all studies ) or have inadequate numbers of patients enrolled to answer the question of efficacy .
OBJECTIVES To determine the best technique for fissure surgery .