Aims and Objectives: To prospectively evaluate and compare effectiveness of topical 0.2% glyceryl trinitrate ointment vs lateral internal sphincterotomy in treatment of patients with chronic anal fissure. Material and Methods: The study included a total of 50 patients presented with chronic anal fissure, divided into two groups by computer generated randomization. Group A included 25 patients with chronic anal fissure treated with local glyceryl trinitrate ointment 0.2% whereas Group B included 25 patients managed by lateral internal sphincterotomy.
Results: The mean age of patients in group A was 34.6±12.8 years and in Group B was 32.12±11.57 years (p>.05). In group A, out of 25 patients, 19 were male and 6 females, whereas in group B, there were 20 males and 5 females. The mean pain score of patients before treatment in group A was 8.64±0.95 where as in group B was 8.44±1.19. At the end of six weeks of treatment the mean pain score was 1.64±2.43 in group A and 0.24±1.20 in group B respectively. Complete healing was observed in 18 out of 25 (72%) patients in group A whereas all 25 (100%) patients in group B had completely healed fissures at the end of six weeks. Except headache which was reported in 9 out of 25 (36%) patients in group A no other side effect was seen in this group. Whereas only 1 out of 25(4%) patients in group B developed haematoma in the perianal area, which was relieved conservatively within 1 week.
Conclusion: Glyceryl trinitrate ointment is a good alternative mode of therapy, hence lateral internal sphincterotomy may be reserved for patients who fail to respond to initial glyceryl trinitrate therapy.
Published on: Apr 30, 2016 Pages: 13-16
Peter Lloyd Nara
Private Compnay- Biological Mimetics, Inc., USA
Annals of Antivirals and Antiretrovirals
Prof. Pierre Guertin
Laval University, Canada
International Journal of Pharmaceutical Sciences and Developmental Research
Rafal Tomasz Pawliczak
Medical University of Lodz, Poland
Open Journal of Asthma
Cardiometabolic Research Institute, USA
Journal of Cardiovascular Medicine and Cardiology
CHA University, Republic of Korea
International Journal of Immunotherapy and Cancer Research