Actively Recruiting

Phase Not Applicable
Age: 18Years - 65Years
All Genders
ID07568314

A Comparative Study of Botulinum Toxin Injection Versus Lateral Internal Sphincterotomy for Chronic Anal Fissure Management

Led by Islamabad Medical and Dental College · Updated on 2026-05-05

90

Participants Needed

1

Research Sites

13 weeks

Total Duration

On this page

AI-Summary

What this Trial Is About

Researchers are comparing two common treatments for chronic anal fissure, a painful condition causing severe discomfort during bowel movements. The study evaluates botulinum toxin injection, a minimally invasive method that temporarily relaxes the anal muscle, and lateral internal sphincterotomy, a minor surgery that permanently reduces muscle pressure. The goal is to find which treatment offers better healing and safety for patients with this condition. Participants will be divided into two groups. One group will receive 20 units of botulinum toxin type A injected into the anal sphincter at two specific points using a fine needle. The other group will undergo lateral internal sphincterotomy, where a small surgical cut is made to divide part of the anal sphincter under spinal anesthesia. This procedure allows the wound to heal naturally. Both treatments aim to relieve symptoms and promote fissure healing. During the study, 90 adult patients will be regularly checked to assess how well the fissure heals within three months, relief from pain, recurrence rates, and any side effects like incontinence. Follow-up visits will monitor healing progress and complications. The study will help determine the effectiveness and safety of each treatment over time, supporting better treatment choices for chronic anal fissure.

CONDITIONS

Brief Title

Comparison of Botulinum Toxin Injection and Lateral Internal Sphincterotomy in Chronic Anal Fissure Management

Who Can Participate

Age: 18Years - 65Years
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Age between 18 and 65 years
  • Diagnosed chronic anal fissure lasting more than 6 weeks
  • Failure of conservative management
  • Both male and female patients
  • Willingness to provide informed consent
Not Eligible

You will not qualify if you...

  • Acute anal fissure
  • Previous anal surgery
  • Inflammatory bowel disease
  • Pregnancy
  • Neurological disorders affecting continence
  • Known hypersensitivity to botulinum toxin

AI-Screening

AI-Powered Screening

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Your Study Journey

Screening

Duration - 2 to 4 weeks

Participants are screened for eligibility to participate in the trial.

Treatment

Duration - Single treatment with healing assessed over 3 months

Participants receive either an intrasphincteric injection of botulinum toxin type A or undergo a lateral internal sphincterotomy procedure to manage chronic anal fissure.

1 treatment visit with follow-up assessments over 3 months

Trial Site Locations

Total: 1 location

1

Islamabad Medical and Dental College

Islamabad, Federal, Pakistan, 44000

Actively Recruiting

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Research Team

P

Prof.Dr Rizwan Aziz

How is the study designed?

Study Type

INTERVENTIONAL

Masking

SINGLE

Allocation

NON_RANDOMIZED

Model

PARALLEL

Primary Purpose

TREATMENT

Number of Arms

2

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