An anal fissure is a linear “tear” within the anal canal that is a result of increased tension of internal anal sphincter that causes an impaired blood supply within the anal mucosa. Anal fissures may be caused by constipation, passage of large, hard stools, prolonged diarrhea, anal sex, childbirth trauma or inflammatory bowel diseases. The symptoms usually include mild anal bleeding and sharp pain in anal region, typically after defecation.
Anal fissures management includes pharmacological treatment (topical agents that reduce the tension within the internal anal sphincter) or direct injection of botulinum toxin. Surgical treatment is usually introduced when pharmacological therapy did not result in the healing process of anal fissure. The surgical treatment includes excision of anal fissure and partial incision of the internal anal sphincter. This procedure may be also performed with the use of laser. The decision about the treatment started is made individually during the consultation with proctologist.