BOTULINUM TOXIN FOR CHRONIC ANAL-FISSURE

Botulinum toxin can chemically denervate striated muscle. Botulinum to xin A (15 U) was used to treat ten patients with chronic anal fissure by injection in the internal sphincter. In seven patients, the lesion healed at 2 months after treatment; one relapsed at 3 months. In one p atient the lesion healed at 1 month, but partly relapsed a month later . Mild faecal incontinence lasting for 1 day was observed in one patie nt. We propose that botulinum toxin injections in the internal anal sp hincter be considered an alternative approach to surgical therapy of a nal fissure.