Comparing Botulinum Toxin Injection and Lateral Internal Sphincterotomy for Treating Chronic Anal Fissure in Adults Aged 18 to 65

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.

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