Comparing Botox Injection Alone Versus Botox Injection Plus Fissurectomy and Anoplasty for Treating Chronic Anal Fissure in Adults

What this Trial Is About

Chronic anal fissure is a common condition causing severe pain during bowel movements, bleeding, and reduced quality of life. It results from a tear in the anal canal that fails to heal due to muscle spasms and poor blood flow. This trial compares two treatments for adults with chronic anal fissure to find out which is more effective and safer injection of Botox alone versus Botox combined with surgery involving fissure removal and tissue repair. The study involves two groups. One group will receive a Botox injection into the internal anal sphincter muscle to relax it temporarily and promote healing. The other group will receive the same Botox injection followed by surgical removal of the fissure and surrounding fibrotic tissue, along with an advancement flap anoplasty to cover the area with healthy tissue. Both procedures are done under anesthesia, and standardized care protocols will be followed. Participants will be monitored over time for healing of the fissure, relief from pain, recurrence of the fissure, continence status, complications, and satisfaction with treatment. Follow-up visits will include clinical assessments using pain scales and continence scores. The main measure is the rate of fissure healing three months after treatment. The study aims to enroll 108 adults aged 18 to 65 who have had chronic anal fissures for over six weeks and did not improve with conservative treatment.

Comparative Outcomes of Inj Botox Alone vs Inj Botox Combined With Fissurectomy and Anoplasty in the Management of Chronic Anal Fissure