Anal Canal Pressure in Anal Fissure Before and After Internal Sphincterotomy

PURPOSE: To assess whether the anal canal pressure is increased in patients with a chronic anal fissure and to examine the effects of internal anal sphincterotomy (IASy) on this pressure. MATERIALS AND METHOD: Anorectal manometry was performed in 28 patients in whom an anal fissure had been diagnosed by means of physical examination and anuscopy. After IASy the manometric measurement was repeated on the 15th postoperative day and compared with the value obtained in twelve healthy volunteers. RESULTS: In patients with chronic anal fissure, the mean maximal resting pressure (MRP) was found to be 112.38 +/- 8.35 cm H2O pre-operatively and 66.23 +/- 8.44 cm H2O postoperatively, with a significant drop after IASy (p < 0.001). The MRP value was found as 75.16 +/- 10.22 cm H2O in the control group. The pre-operative MRP values in patient group was found to be higher than in the control group (p < 0.001). CONCLUSIONS: In patients with chronic anal fissure, the anal canal MRP pressures decreased significantly following IASy and complete clinical recovery was attained.