Document Detail

Topical use of glyceryl-trinitrate in the treatment of anal fissure
MedLine Citation:
PMID:  19536057     Owner:  NLM     Status:  MEDLINE    
AIM: Anal fissure is associated with hypertonia of the internal anal sphincter and pain. Lateral internal sphincterotomy, the most common treatment, may cause permanent injury to the anal sphincter, which can lead to fecal incontinence. The aim of this study was to evaluate the effectiveness of topical glyceryl trinitrate (GTN) ointment in the treatment of anal fissure. METHODS: Twenty-four patients (12 males and 12 females, mean age 45 years) with anal fissure received 0.4% GTN gel twice a day for a minimum of six weeks. All patients were followed at regular intervals of 2, 6, 12 weeks to assess symptom outcome, rate of healing, adverse effects and recurrence rate. RESULTS: The symptomatology was significantly improved already from the second week of treatment in 18 patients (75%). Thirteen patients (54%) healed after six weeks, and 14 (58%) after 12 weeks, while three patients (13%) partially healed but asymptomatic. Fecal incontinence was absent. In two patients (8%) treatment was interrupted because of severe headaches. At the end of the treatment, only three patients (13%) underwent lateral sphincterotomy. CONCLUSIONS: Topical application of GTN ointment heals anal fissures and represents an alternative to the traditional first-line treatment of surgical sphincterotomy.
F Corno; A Marano; S Volpatto; P Mistrangelo
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Publication Detail:
Type:  Clinical Trial; English Abstract; Journal Article    
Journal Detail:
Title:  Minerva chirurgica     Volume:  64     ISSN:  0026-4733     ISO Abbreviation:  Minerva Chir     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-18     Completed Date:  2009-12-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0400726     Medline TA:  Minerva Chir     Country:  Italy    
Other Details:
Languages:  ita     Pagination:  307-11     Citation Subset:  IM    
Chirurgia Generale 1, Universit?? degli Studi di Torino, Azienda Ospedaliero-Universitaria,Torino, Italia.
Vernacular Title:
Uso topico di gliceril-trinitrato nel trattamento della ragade anale.
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MeSH Terms
Administration, Cutaneous
Anal Canal / surgery
Fissure in Ano / drug therapy*,  surgery
Medication Adherence
Middle Aged
Nitroglycerin / administration & dosage,  therapeutic use*
Ointments / therapeutic use
Retrospective Studies
Time Factors
Treatment Outcome
Vasodilator Agents / administration & dosage,  therapeutic use*
Wound Healing
Reg. No./Substance:
0/Ointments; 0/Vasodilator Agents; 55-63-0/Nitroglycerin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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