The role of internal sphincter in chronic anal fissures

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Abstract
Changes in anal sphincter manometric pressures in response to rectal distention were measured in 8 patients with chronic anal fissures and were compared with those of 10 controls. No statistically different resting pressures were noted between the 2 groups. Overshoot phenomenon was more commonly seen in patients with fissure. There were no differences in the anal sphincteric pressures after lateral internal sphincterotomy (LIS) or fissurectomy midline sphincterotomy (FMS). All fissures healed postoperatively, irrespective of the surgical technique (LIS or FMS) or the pressure readings. The therapeutic effect of sphincterotomies might at least in part be due to anatomic widening of the anal canal rather than to decreased resting pressures of the internal sphincter.

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