BACKGROUND Chronic anal fissure is the most common cause of anal pain associated with internal anal sphincter hypertonia. Reduction of hypertonia favours fissure healing. Temporary reduction in sphincter tone can be achieved by conservative treatment. Surgical sphincterotomy achieves permanent reduction of sphincter hypertonia and is very successful at healing anal fissures, but requires an ope...

introduction: vesicovaginal fistula remains a challenge in surgical therapy. in this study autologous platelet rich plasma and platelet rich fibrin glue were used as a minimally invasive approach for vesicovaginal fistula closure. materials and methods: data including age, parity, iciq-ui (international consultation on incontinence questionnaire-urinary incontinence), iciq-qol (international co...

EXECUTIVE SUMMARY Urinary incontinence (UI) has been defined as a condition in which the involuntary loss of urine is a social or hygienic problem and is objectively demonstrable. Urinary incontinence is a common health problem that carries with it significant medical, psychosocial and economic burdens. Fecal incontinence has been defined as the involuntary or inappropriate passing of liquid or...

OBJECTIVE To summarise current knowledge of Internal anal sphincter. BACKGROUND The internal anal sphincter (IAS) is the involuntary ring of smooth muscle in the anal canal and is the major contributor to the resting pressure in the anus. Structural injury or functional weakness of the muscle results in passive incontinence of faeces and flatus. With advent of new assessment and treatment mod...

Background: The author describes a technique of closed manipulation of the fibers of the internal anal sphincter to relieve anal spasm in patients with chronic anal fissures. Patients and methods: 301 patients with chronic anal fissures treated with this technique were enrolled for the study. Preoperative and postoperative anal manometry was recorded. An independent observer assessed postoperat...

Background: The author describes a technique of closed manipulation of the fibers of the internal anal sphincter to relieve anal spasm in patients with chronic anal fissures. Patients and methods: 301 patients with chronic anal fissures treated with this technique were enrolled for the study. Preoperative and postoperative anal manometry was recorded. An independent observer assessed postoperat...

BACKGROUND Botulinum neurotoxin induces healing in patients with idiopathic fissure. The optimal dosage is not well established. AIM To compare the efficacy and tolerability of two different formulations of type A botulinum neurotoxin, and to provide more evidence with regard to the choice of dosage regimens. METHODS Symptomatic adults with chronic anal fissure were enrolled in a randomized...

BACKGROUND The author describes a technique of closed manipulation of the fibers of the internal anal sphincter to relieve anal spasm in patients with chronic anal fissures. PATIENTS AND METHODS 301 patients with chronic anal fissures treated with this technique were enrolled for the study. Preoperative and postoperative anal manometry was recorded. An independent observer assessed postoperat...

OBJECTIVE To summarise the results of transanal endoscopic microsurgery for the treatment of rectal villous adenoma and early rectal tumours. DESIGN Prospective study. SETTING Regional hospital, Hong Kong. PATIENTS Consecutive patients between November 1995 and January 2003. INTERVENTION Transanal endoscopic microsurgery. MAIN OUTCOME MEASURES Intra-operative morbidity and mortality, ...