title: Fissure-in-ano: the initial management and prognosis.
abstract: 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: D000293:Adolescent; D000328:Adult; D000368:Aged; D001004:Anus Diseases / Q000150:complications; D002648:Child; D002675:Child, Preschool; D005260:Female; D005401:Fissure in Ano / Q000150:complications / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011379:Prognosis