What predicts successful nonoperative management with botulinum toxin for anal fissure?

Kyriakakis, Roxanne; Kelly-Schuette, Kathrine A.; Hoedema, Rebecca; Luchtefeld, Martin; Ogilvie, James W.

doi:10.1016/j.amjsurg.2019.10.012

Cited by 5 publications

(4 citation statements)

References 10 publications

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“…Topical nitrate medications may potentiate the effects of botulinum toxin in patients with refractory anal fissure (163). Predictors of efficacy may include female sex, satisfaction with the first procedure, and a lower body mass index (164). Patients in whom medical treatment or botulinum toxin A injection fail should be recommended for lateral internal sphincterotomy (LIS) (165).…”

Section: Minimally Invasive Proceduresmentioning

confidence: 99%

ACG Clinical Guidelines: Management of Benign Anorectal Disorders

et al. 2021

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Benign anorectal disorders of structure and function are common in clinical practice. These guidelines summarize the preferred approach to the evaluation and management of defecation disorders, proctalgia syndromes, hemorrhoids, anal fissures, and fecal incontinence in adults and represent the official practice recommendations of the American College of Gastroenterology. The scientific evidence for these guidelines was assessed using the Grading of Recommendations Assessment, Development and Evaluation process. When the evidence was not appropriate for Grading of Recommendations Assessment, Development and Evaluation, we used expert consensus to develop key concept statements. These guidelines should be considered as preferred but are not the only approaches to these conditions.

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Section: Minimally Invasive Proceduresmentioning

confidence: 99%

ACG Clinical Guidelines: Management of Benign Anorectal Disorders

et al. 2021

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“…27 Only 1 retrospective review addressed risk factors for nonhealing, demonstrating that predictors of success with botulinum toxin included female sex and lower BMI. 28 Prospective studies suggest that in direct comparison with 0.2% to 1% topical nitroglycerin and 0.2% topical nifedipine, botulinum toxin (20-60 units) is associated with healing in 67% of patients, which is comparable to the 71% reported with topical therapies. 29,30 A doubleblind randomized trial comparing topical 2% DTZ with 20 units of botulinum toxin (using placebo injections and topical preparations, respectively) demonstrated that both treatment arms were associated with a 43% healing rate after 3 months, and similar rates of patients reporting at least a 50% reduction in pain score (82% vs 78%; p = 0.142)).…”

Section: Botulinum Toxin Has Similar Results Compared With Topical Th...mentioning

confidence: 84%

“…27 Only 1 retrospective review addressed risk factors for nonhealing, demonstrating that predictors of success with botulinum toxin included female sex and lower BMI. 28…”

Section: Recommendationsmentioning

confidence: 99%

The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Anal Fissures

Davids¹,

Hawkins²,

Bhama³

et al. 2022

Diseases of the Colon &Amp; Rectum

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“…Botulinum toxin A is used in gastroparesis treatment [1], esophagus motility disorders [2], and anal fissures [3]. Botulinum toxin A injection after proctectomy was proposed more recently by our team for treating fecal incontinence [4].…”

mentioning

confidence: 99%