Botulinum toxin (popularly known as Botox) has always been used in the medical field to treat medical problems related to muscle spasm. In this sense, it has gained prominence as an alternative to surgery in cases of anal fissure in patients with impaired continence.
According to experts in Proctology, the bad press that lateral internal sphinctertomy has in terms of posterior incontinence is absolutely false, as long as this technique is performed correctly, by expert hands, and the patient is evaluated as a whole. Today, the treatment par excellence in terms of efficacy, cure and durability is still surgery (sphincterotomy).
However, in patients with previous sphincter alterations (surgical iatrogenesis, complicated deliveries with obstetric trauma or advanced age), it can be a good therapeutic alternative.
Advantages and disadvantages of botulinum toxin in anal fissure
Advantages of botulinum toxin for anal fissure
- It is reversible, and after 6 months the patient recovers his previous continence and the fissure has already healed.
- It is not very traumatic, and can be performed under sedation and on an outpatient basis.
- Normal life can be resumed the following day.
- The patient improves rapidly in the first 24-48 hours, which is the time it takes for the medication to act on the sphincter spasm.
Disadvantages of botulinum toxin for anal fissure
- The duration of treatment is about 4 months.
- The treatment is expensive, since botulinum toxin is expensive in itself and also requires hospital management.
- On some occasions there have been infections at the infection sites.
- There have been cases of gas incontinence during medication.