TREATMENT OF CHRONIC FISSURE-IN-ANO WITH GLYCERYL TRINITRATE
Keywords:
Fissure, sphincterotomy, Glyceryl Trinitrate Cream (GTN), constipationAbstract
Objectives: To determine the role of 0.2% topical glyceryl trinitrate in the treatment for chronic anal fissure.
Material and Methods: This descriptive study was carried out in Khyber Teaching Hospital, Peshawar from January
2004 to September 2007. Patients with a 6 weeks history of primary chronic anal fissure were included in the study. All
patients were diagnosed on the basis of history and clinical examination. After advising application of glyceryl trinitrate
0.2% on the anal verge, patients were followed on 10th, 20th, 40th day and 6 months.
Results: A total of 73, including 58 (79.4%) male and 15 (20.5%) female patients with mean age of 39 years were
included. Complete resolution was observed in 42 (57.5%) patients while 22 (30.1%) cases had partial response, 5
(6.8%) patients had no response. In the failure group 4 patients underwent surgical intervention.
Conclusion: Glyceryl trinitrate (0.2%) cream is an effective treatment for chronic anal fissure, having unnecessary
surgery.
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