Fissure-in-ano: the initial management and prognosis

Br J Surg. 1977 May;64(5):355-8. doi: 10.1002/bjs.1800640516.


The results of treatment of 188 consecutive new patients with a primary diagnosis of fissure-in-ano presenting to the Outpatient Department of St Mark's Hospital are reviewed. One-third underwent operation as the primary treatment and were not studied further. Of the remaining patients who underwent non-operative treatment only, one-half were initially cured. Follow-up at 4 years showed that this cure was maintained in half of these cases, suggesting that there is a place for treatment with a dilator in the correctly selected case. The presence of a sentinel skin tag or a fibrous anal polyp is shown to have a statistically significant association with operative treatment. The use of a paediatric sigmoidoscope to diagnose a fibrous anal polyp is recommended.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anus Diseases / complications
  • Child
  • Child, Preschool
  • Female
  • Fissure in Ano / complications
  • Fissure in Ano / surgery
  • Fissure in Ano / therapy*
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Prognosis