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Lateral internal sphincterotomy is the preferred method of surgery for persons with chronic anal fissures, and is generally used when medical therapy has failed. [1] It is associated with a lower rate of side effects than older techniques such as posterior internal sphincterotomy and anoplasty, [3] and has also been shown to be superior to topical glyceryl trinitrate (GTN 0.2% ointment) in ...
Surgical Therapy (for chronic fissures or when non-surgical therapy fails) : Anal Dilation, [8] Lateral Internal Sphincterotomy, Advancement Flaps, Fissurectomy. Anorectal Abscess and Fistula Painful swelling, [ 5 ] Redness, Pain, [ 10 ] Bloody diarrhea, [ 11 ] an opening can point to a fistula, with or without drainage [ 5 ] with itchiness.
The surgeon can perform the simplest technique by making a horizontal incision and closing along the longitudinal axis. However, the methods that give patients higher satisfaction are the single or double Z-plasty or V-Y advancement flap because they also can increase the penile length. [15]
Anal sphincterotomy is a surgical procedure that involves treating mucosal fissures from the anal canal/sphincter. [ 1 ] [ 2 ] The word is formed from sphincter + otomy (to cut, to separate). [ 3 ]
An anal fissure is a break or tear in the skin of the anal canal. Anal fissures may be noticed by bright red anal bleeding on toilet paper and undergarments, or sometimes in the toilet. If acute they are painful after defecation , [ 1 ] but with chronic fissures, pain intensity often reduces and becomes cyclical.
Complications of the surgery are rare, including pain and infection, which may require implant removal in 5% of cases. The effects of SNS may include increased resting and squeeze anal tone, and improved rectal sensitivity. There is reported reduction of involuntary loss of bowel contents and increased ability to postpone defecation.
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