Treatment Option for Aged, Multiparous Women With a Chronic Anal Fissure

Yong Hee Hwang

doi:10.3393/ac.2014.30.3.106

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Editorial Treatment Option for Aged, Multiparous Women With a Chronic Anal Fissure: Yong Hee Hwang; Annals of Coloproctology 2014;30(3):106-106.
DOI: https://doi.org/10.3393/ac.2014.30.3.106
Published online: June 23, 2014

Department of Surgery, Sahmyook Medical Center, Seoul, Korea.

Correspondence to: Yong Hee Hwang, M.D. Department of Sugery, Sahmyook Medical Center, 82 Mangu-ro, Dongdaemun-gu, Seoul 130-711, Korea. Tel: +82-2-2210-3563, Fax: +82-2-2212-2673, hwangyon@hotmail.com

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Chronic anal fissures are a common disease and show a high recurrence rate even though after various treatment modalities have been applied. The lateral internal sphincterectomy is the most successful treatment modality, but is difficult to apply to aged patients or multiparous women due to postoperative fecal incontinence [1, 2]. In these cases, a stepwise approach of Diltiazem and Botox injection with an anal fissurectomy is a good alternative for reducing postoperative fecal incontinence [3]. However, the high treatment cost and the lengthy treatment time are two obstacles that need to be resolved, so pretreatment counseling and strict indications for the selection of such a treatment modality are essential.

REFERENCES

1. Corby H, Donnelly VS, O'Herlihy C, O'Connell PR. Anal canal pressures are low in women with postpartum anal fissure. Br J Surg 1997;84:86–88. Article PubMed
2. Frudinger A, Halligan S, Bartram CI, Price AB, Kamm MA, Winter R. Female anal sphincter: age-related differences in asymptomatic volunteers with high-frequency endoanal US. Radiology 2002;224:417–423. Article PubMed
3. Farouk R. Sphincter-preserving therapy for treating a chronic anal fissure: long-term outcomes. Ann Coloproctol 2014;30:132–134.Article PubMed PMC

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Treatment Option for Aged, Multiparous Women With a Chronic Anal Fissure

Ann Coloproctol. 2014;30(3):106-106. Published online June 23, 2014

DOI: https://doi.org/10.3393/ac.2014.30.3.106

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Treatment Option for Aged, Multiparous Women With a Chronic Anal Fissure