Chronic anal fissure rarely heals spontaneously. About 50% heal on administration om topical muscle relaxants (e.g. diltiazem) and/or injection of Botulinum toxin, but for the remainder of patients surgery (with lateral internal sphincterotomy or fissurectomy) with subsequent risks of anal incontinence has been the golden standard. Treatment with PTNS (percutaneous tibial nerve stimulation) has been showed to produce healing of chronic anal fissures not responding to topical treatment, thus avoiding the risk for debilitating anal incontinence.
This study will prospectively include 52 patients with chronic anal fissure that have received topical treatment and stool softeners and have all been evaluated by experienced proctological surgeons. The treatment will be given for 10 consecutive work days and then evaluated at 3 and 12 months. If the patients symptoms are unimproved at 3 months alternative treatments will be offered.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
52
Patients meeting the criteria are treated with PTNS and are evaluated at 3 months and 1 year after end of treatment.
Skåne University Hospital
Malmo, Sweden
Healing rate
Healing of anal fissure from assessement of clinical and/or data from patient form
Time frame: 3 months after treatment
Healing rate
Healing of anal fissure from assessement of clinical and/or data from patient form
Time frame: 12 months after treatment
Bowel movements
Changes in frequency of bowel emptying and consistency of bowel contents Before and after treatment
Time frame: 3 months after treatment
Bowel movements
Changes in frequency of bowel emptying and consistency of bowel contents Before and after treatment
Time frame: 12 months after treatment
Adverse effects
Reports of adverse effects (subjective/objective)
Time frame: 3 months after treatment
Adverse effects
Reports of adverse effects (subjective/objective)
Time frame: 12 months after treatment
Smoking
Differences in healing rates between smokers and non-smokers
Time frame: 3 months after treatment
Smoking
Differences in healing rates between smokers and non-smokers
Time frame: 12 months after treatment
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