Usefullness of topical glyceryl trinitrate in chronic anal fissure

ABSTRACT

To assess the effectiveness of topical Glyceryl Trinitrate in the treatment of Chronic Anal Fissure. Prospective Observational study from April 2004 to March 2005. Surgical Unit II, Peoples Medical College Hospital, Nawabshah. A total of 46 patients with Chronic Fissure-in-Ano. The data of all the patients who were recruited for the use of 0.2% topical Glyceryl Trinitrate was collected and analyzed for gender, age, symptoms' duration, site, and associated diseases. These patients were followed at regular intervals of four, six, eight and 12 weeks, and six and 12 months to assess the outcome, adverse effects and recurrence. Out of the 46 patients, six did not came back for follow-up, hence they were excluded. Amongst the remaining 40 cases, there were 14 males and 26 females, with ages between 16-64 years. In 26 [65%] patients, the fissure healed completely during eight weeks duration, whereas 10 [25%] patients experienced headache. Recurrence occurred in six [15%] patients; in them lateral internal sphincterotomy was performed. Topical Glyceryl Trinitrate is a good treatment option, as the success rate was 65%, with only 15% recurrence. It is well tolerated and has no chances of faecal and flatus incontinence