ArticleInternational journal of colorectal disease2022
Botulinum toxin injection for the treatment of chronic anal fissure: uni- and multivariate analysis of the factors that promote healing.
Article in International journal of colorectal disease, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.
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Who cites it
7 citing papers in PubMed, 2 syntheses or guidelines pooled it, 25 citations in OpenAlex.
- Comparative Efficacy and Safety of Botulinum Toxin and Nitroglycerin in the Treatment of Chronic Anal Fissures: A Systematic Review and Meta-Analysis of Clinical Trials.BioMed research international · 2026Pooled it
- Botox in below knee amputation for the management of post-operative contracture: a systematic review.The Pan African medical journal · 2024Pooled it
- Efficacy of botulinum toxin in the treatment of chronic anal fissure: a comprehensive systematic review.Annals of medicine and surgery (2012) · 2025Article
- Is chemodenervation with incobotulinumtoxinA an alternative to invasive chronic anal fissure treatments?BMC gastroenterology · 2024Article
- Botulinum toxin type A injection combined with biofeedback in the treatment of spastic pelvic floor syndrome.World journal of clinical cases · 2024Article
- Assessment of Quality of Life in Patients with Chronic Anal Fissures: A 1-Year Follow-Up Study before and after Botulinum Toxin (Botox) Injection.Journal of clinical medicine · 2024Article
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeAnal fissure is caused by a pathological contraction of the internal anal sphincter. Lateral internal sphincterotomy remains the gold standard for the treatment of fissure. Botulinum toxin injections have been proposed to treat this condition without any risk of permanent injury of the internal sphincter. We investigate clinical and pathological variables and the effects of different dosage regimens of botulinum toxin to induce healing in patients with idiopathic anal fissure.
methodsThis is a retrospective study at a single center. The patients underwent a pre-treatment evaluation that included clinical inspection of the fissure and anorectal manometry. We collected and analyzed demographic data, pathological variables, associated pathological conditions, and treatment variables. Success was defined as healing of the fissure, and improvement of symptoms was defined as asymptomatic persistent fissure.
resultsThe findings of 1003 patients treated with botulinum toxin injections were reported. At 2 months evaluation, complete healing was evident in 780 patients (77.7%). Resting anal tone (77.1 ± 18.9 mmHg) was significantly lower from baseline (P < 0.0001) and from 1-month value (P = 0.0008). Thirty-nine not healed patients underwent lateral internal sphincterotomy, and 184 were re-treated with 50 UI of botulinum toxin. In these patients, the healing rate was 93.9% (171 patients). Dose and injection site of toxin correlates with healing rate. There were no relapses during an average of about 71 months.
conclusionOur data show that injection of botulinum toxin into the internal anal sphincter is a safe and effective alternative to surgery in patients with chronic anal fissure.
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