Lateral internal sphinterotomy (LIS) is the gold standard against which all treatments are compared with a healing rate over 92%. However, the most serious complication of this procedure is anal incontinence. To overcome these problems, continued efforts are being tried to find less invasive treatments modalities for anal fissure that is as effective as surgical therapy with lower morbidity.
Sacral nerve stimulation has been recently tried for management of chronic anal fissure with promising results. However, the technique described is invasive with the need for surgically implantable expensive stimulator electrodes. The aim of this study was to evaluate the efficacy of posterior tibial nerve stimulation (PTN) by transcutaneous electrical nerve stimulation (TENS) and to compare it to the conventional LIS. This non-invasive technique has been proved to be of acceptable results in treatment of fecal incontinence and urinary incontinence.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
94
number of patients with clinical improvement of symptoms
Resolution of anal pain after the procedure
Time frame: one year
number of patients with post-procedure anal incontinence according to Pescatory grading and scoring index for anal incontinence
Time frame: one year
Number of patients with improvement of constipation according to Wexner constipation score
Time frame: one year
Anal pain scores on VAS
Time frame: one month
Post-procedure patient satisfaction on VAS
Time frame: one year
Number of patients with healed anal fissure
Complete epithelialization of the fissure
Time frame: one month
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