How is sphincter dilatation performed in the surgical treatment of anal fissure?

Updated: Nov 28, 2018
  • Author: Lisa Susan Poritz, MD; Chief Editor: John Geibel, MD, DSc, MSc, AGAF  more...
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Answer

This procedure is a controlled anal stretch or dilatation under general anesthetic. It is performed because one of the causative factors for anal fissure is thought to be a tight internal anal sphincter. Stretching the tight sphincter helps correct the underlying abnormality, thus allowing the fissure to heal. The number of fingers used and the amount of time for which the stretch is applied vary among surgeons.

Although the sphincter stretch does provide symptomatic relief from the anal fissure, it is rarely performed today, because of the high complication rate. Impaired continence is observed in 12-27% of patients as a consequence of uncontrolled stretching and subsequent tearing of the internal and external sphincter.


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