What is the efficacy of botulinum toxin for the treatment of anal fissure?

Updated: Jul 24, 2020
  • Author: Lisa Susan Poritz, MD; Chief Editor: John Geibel, MD, MSc, DSc, AGAF  more...
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In a review of four prospective, randomized, controlled trials that included a total of 279 patients, Shao et al concluded that surgery—specifically, lateral internal sphincterotomy—was more effective than botulinum toxin injection for healing chronic anal fissures. [10] For surgery as compared with toxin injection, there was an absolute benefit increase rate of 23%, with toxin injection associated with a lower fissure healing rate and a higher recurrence rate. However, the incidence of minor anal incontinence was higher with surgery.

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