Fissure Treatment
  • Chemical Sphincterotomy (a non operative painless technique using Injection Botox)
  • Closed Internal Sphincterotomy (Day Care Surgery).

Chemical Sphincterotomy (a non operative painless technique using Injection Botox)

Chemical Sphincterotomy uses botulinum toxin (BOTOX injection) therapy for acute and chronic anal fissures. The toxin is injected directly into the internal anal sphincter (the circular internal muscles of the anal sphincter that controls the passage of feces). The most common cause for non-healing of anal fissure is spasming of the internal anal sphincter muscle which results in impaired blood supply to the anal mucosa. The injection prevents spasming and this effect lasts approximately three months, until the nerve endings regenerate. This period allows the fissure to heal and the symptoms to resolve.


Closed Internal Sphincterotomy (Day Care Surgery).

Closed Internal Sphincterotomy is a surgical treatment for chronic anal fissure. It is performed on the internal anal sphincter muscle (the circular internal muscles of the anal sphincter that controls the passage of feces). The internal anal sphincter is one of two muscles that comprise the anal sphincter. This surgical procedure lowers the resting pressure of the internal anal sphincter without destroying the effect of the sphincter. The internal anal sphincter is partially divided to reduce spasming. This improves the blood supply to the area and helps to heal the fissure.

This is done as a day care procedure. Internal Sphincterotomy (LIS) is recommended for its simplicity and its high rate of success (about 95%). The closed technique results in a smaller wound and is very effective.

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