title: [Intra-anal application of isosorbide dinitrate in chronic anal fissure].
abstract: OBJECTIVE
  To evaluate the effect of intra-anal application of isosorbide dinitrate on the healing rate of chronic anal fissure.
  
  
  METHODS
  Prospective, descriptive.
  
  
  METHODS
  Outpatient clinic of the department of Surgery, University Hospital Dijkzigt, Rotterdam.
  
  
  METHODS
  Sixteen patients with chronic (more than three months' duration) anal fissure were treated by intra-anal application of isosorbide dinitrate ointment every 3 hours, except during the night. The maximal duration of therapy was 12 weeks. Every three weeks the following aspects were investigated: clinical symptoms, side-effects and fissure healing.
  
  
  RESULTS
  All patients experienced mild and transient headache shortly after the beginning of the treatment. At three weeks the fissure-related pain was resolved in all patients. At 6, 9 and 12 weeks the fissure was completely healed in 9, 11 and 15 patients respectively.
  
  
  CONCLUSIONS
  The majority of chronic anal fissures can be treated effectively by local application of isosorbide dinitrate. This new and simple treatment modality appears to be an attractive alternative to the currently available surgical procedures.
authors.affiliation: Afd. Heelkunde, Academisch Ziekenhuis Rotterdam-Dijkzigt.
authors.forename: W R
authors.initials: WR
authors.lastname: Schouten
authors.forename: J W
authors.initials: JW
authors.lastname: Briel
authors.forename: J J
authors.initials: JJ
authors.lastname: Auwerda
authors.forename: M O
authors.initials: MO
authors.lastname: Boerma
authors.forename: B H
authors.initials: BH
authors.lastname: Graatsma
authors.forename: E B
authors.initials: EB
authors.lastname: Wilms
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D001003:Anal Canal; D002908:Chronic Disease; D005260:Female; D005401:Fissure in Ano / Q000188:drug therapy*; D006801:Humans; D007548:Isosorbide Dinitrate / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009824:Ointments; D011446:Prospective Studies
chemical_list: D009824:Ointments; D007548:Isosorbide Dinitrate
vernacular_title: Intra-anale applicatie van isosorbidedinitraat bij chronische fissura ani.