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Lancet. 1994 Oct 22;344(8930):1127-8.

Botulinum toxin for chronic anal fissure.

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  • 1Istituto di Clinica Chirurgica, Universit√† Cattolica del Sacro Cuore, Roma, Italy.


Botulinum toxin can chemically denervate striated muscle. Botulinum toxin 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 patient the lesion healed at 1 month, but partly relapsed a month later. Mild faecal incontinence lasting for 1 day was observed in one patient. We propose that botulinum toxin injections in the internal anal sphincter be considered an alternative approach to surgical therapy of anal fissure.

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