Manometric Study of Topical Sildenafil (Viagra®) in Patients With Chronic Anal Fissure: Sildenafil Reduces Anal Resting Tone

Abstract

Topical administration of a phosphodiesterase-5 inhibitor (sildenafil, Viagra) significantly reduces anal sphincter pressure in patients with chronic anal fissure. A beneficial effect of nitric oxide on the spastic anal sphincter has been demonstrated previously. This study confirms that this effect need not be derived solely from nitric oxide donors. New therapeutic avenues for treatment of anal fissure through indirect enhancement of nitric oxide activity are suggested.

Effect of sildenafil on wound healing: an experimental study

“…There are some trials focusing on new areas of use sildenafil, including chronic anal fissure [16,17], primary pulmonary hypertension [18], the increasing of retinal blood flow [19], and hypercontractile eosophageal motility disorders [20]. Eherer et al [21] reported that sildenafil reduced basal pressure and sphincter volume of the lower oesophageal sphincter.…”

Inhibitory Effects of Sildenafil Citrate on the Tonus of Isolated Dog Internal Anal Sphincter

“…More recently, Torrabadella et al 24 showed that topical application of sildenafil decreases anal sphincter pressure in patients with chronic anal fissure. Our in vitro study supports this clinical investigation and helps to explain the mechanisms of relaxing action of sildenafil citrate on IAS.…”

“…Healing rates of fissura ani has been reported to be >90 percent after lateral internal sphincterotomy. 24 However, several complications, including risk of incontinence, itching, and soilage, may occur after surgical division of the IAS.…”

A review of chronic anal fissure management

“…Some work has been conducted into their use in the treatment of anal fissures. Torrabadella et al studied the effect of topical application of 10% sildenafil (a phosphodiesterase-5 inhibitor) on the anal sphincter tone of patients suffering from chronic anal fissures [175]. Anal tone was reduced by an average of 18% in less than 3 minutes.…”