Bahzad W Hamad‎ --- Faruk H Faraj

Basrah Journal of Surgery مجلة البصرة الجراحية
ISSN: 16833589 Year: 2004 Volume: 10 Issue: 2 Pages: 75-80
Publisher: Basrah University جامعة البصرة


This is a prospective study to test the hypothesis that topical isosorbide dinitrate (Isordil) is the best first ‎line of treatment of a chronic anal fissure. This study was done in the outpatient clinic of Sulaimani ‎Teaching Hospital, Sulaimani, Iraq, from the 1st Dec. 2000 through 30th May 2002. There were 65 cases ‎of chronic anal fissure treated with 0.5% Isordil ointment and reviewed at 2, 4, 6 and 12 weeks to assess ‎the symptoms, side-effects, fissure healing and patient acceptance. The age range was 2-65 years with ‎mean age of 31.2years, and female:male was 1.4:1. At 12 weeks 80% of patients had no fissure. In 20% ‎the treatment was unsuccessful. At 6 months follow-up there was 2.5 % recurrence. The prevalence of ‎headache was 46.1% on commencing treatment with 12.3% headache-related noncompliance. The cost ‎of treatment with this new method was 12 ID for 8 weeks while it was 36 ID for the same period of ‎traditional way of treatment. We conclude that medical sphincterotomy with 0.5% Isordil ointment is a ‎feasible, cost-effective method of treatment of chronic anal fissure with high patient acceptance and ‎satisfaction.‎