Botulinum toxin injections
Operation
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Prendre rendez-vousIndication
- Anal fissures that show no response to non-surgical treatment.
- Acute anal fissure in women.
Surgical procedure: Fissurectomy with injection of Botulinum® toxin
A chronic fissure is a non-healing wound in the anal canal that has been present for weeks or months.
During a fissurectomy, the wound edges and base of the wound are excised and scraped, so that the wound can granulate from the bottom up on a healthy wound base.
Botulinum toxin is injected into the anal sphincter under general anesthesia. Postoperative pain lasts for about 3 days.
A bottle of botulinum toxin costs 170€ in pharmacies and is not reimbursed by the medical aid (INAMI – RIZIV).
Botulinum toxin temporarily relaxes the anal sphincter, increasing the blood supply to the fissure so that it can heal and reduce spasms and pain. The effect of botulinum toxin disappears completely after 3 months.
- Treatment is successful in 60-80% of cases.
- The long-term recurrence rate is 40-50%.
Normal – abnormal symptoms
Normal symptoms
- Anal pain is normal but should subside over time.
- Seepage of serous (yellowish) anal fluid.
- Fluid loss may be bloody but should subside over time.
Abnormal symptoms
Contact your surgeon or GP, or go to the emergency room:
- If pain increases over time.
- If fever does not subside over time.
- If pus volume increases or foul smelling viscous fluid increases.
- If blood loss persists.
If certain symptoms seem abnormal to you contact your doctor.
If this is not possible, you can contact avec your surgeon.
If you are unable to contact your GP or your surgeon, go to the emergency department at St Elizabeth Hospital in Uccle.
Functional Results
Incontinence
- After injection, there is temporary incontinence for gas in 18% of cases and in 5% for liquid stools. The incontinence is temporary.