Treatment options for chronic anal fissure

A Comparative Efficacy and Safety Study of Lateral Subcutaneous Sphincterotomy and Botulinum Toxin Type A in the Treatment of Chronic Anal Fissure

PHASE4 · State Scientific Centre of Coloproctology, Russian Federation · NCT03855046

This study tests whether using botulinum toxin after surgery can help people with chronic anal fissures heal better and avoid complications compared to a different surgical method.

Quick facts

PhasePHASE4
Study typeInterventional
Enrollment340 (estimated)
Ages18 Years to 70 Years
SexAll
SponsorState Scientific Centre of Coloproctology, Russian Federation (other gov)
Locations7 sites (Podolsk, Moscow Oblast and 6 other locations)
Trial IDNCT03855046 on ClinicalTrials.gov

What this trial studies

This study evaluates the effectiveness and safety of using botulinum toxin compared to lateral subcutaneous sphincterotomy for treating chronic anal fissures. Chronic anal fissures are painful tears in the anal canal that persist for over two months and often do not respond to non-surgical treatments. The study aims to address the high rates of relapse associated with non-surgical methods and the complications of surgical treatments, particularly anal incontinence. By administering botulinum toxin after fissure excision, the study seeks to improve patient outcomes and reduce complications.

Who should consider this trial

Good fit: Ideal candidates for this study are adults diagnosed with chronic anal fissures who have not responded to non-surgical treatments.

Not a fit: Patients with inflammatory bowel diseases, severe hemorrhoids, or previous surgeries on the anal canal may not benefit from this study.

Why it matters

Potential benefit: If successful, this treatment could significantly reduce pain and improve healing for patients suffering from chronic anal fissures.

How similar studies have performed: Previous studies have shown promising results with botulinum toxin for anal fissures, indicating potential for success in this approach.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Patients with chronic anal fissure

Exclusion Criteria:

* Inflammatory diseases of the colon
* Pectenosis
* Previous surgical interventions on the anal canal
* IV grade internal and external hemorrhoids
* Rectal fistula
* Severe somatic diseases at the decompensation stage
* Pregnancy and lactation
* Individual intolerance and hypersensitivity to botulinum toxin
* Myasthenia gravis and myasthenia-like syndromes
* Anal sphincter insufficiency

Where this trial is running

Podolsk, Moscow Oblast and 6 other locations

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.

View on ClinicalTrials.gov →

Conditions: Fissure in Ano, Internal sphincterotomy, Anal fissure, Chronic anal fissure, botulinum toxin A, proctologic diseases, surgical treatment, Chronic anal pain

Last reviewed 2026-05-15 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.