ANAL FISSURE

Abstract

Objectives: To compare role of topical
glycerol trinitrate Ointment with lateral internal sphincterotomy. Setting: Department of Surgery CMH Kohat & PAF
Hospital Karachi. Period: From Mar 2003 to August 2004. Patients & Methods: Sixty patients suffering from chronic
anal fissure were selected and equally divided into two groups. Group A was managed by topical glycerol trinitrate
(GTN) ointment and group B was treated by internal sphincterotomy. Patients were followed up in the out-patient
department fortnightly. Results: Eight weeks after treatment, 66.6% patients in group A and 86.5% patients in group
B had healed fissures. Complications seen in group A were headache 9(30%), anal horny sensation 4(13.3%) and
perianal soiling 2(6.7%) patients. In group B complications included infection 2(6.7%), soiling of under clothes 5(16.7%)
and flatus incontinence 4(13.2%)patients. Conclusions: Although topical GTN ointment is non-invasive therapy with
no permanent complications, it achieves low healing rates as compared to lateral internal sphincterotomy.