A study of hypertrophied anal papillae and fibrous polyps associated with chronic anal fissures.
BACKGROUND
Hypertrophied anal papillae and fibrous anal polyps are not given due importance in the proctology practice. However, they do cause a few disturbing symptoms. This study describes the advantages of the removal of such pathologies associated with chronic anal fissure.


METHODS
Following lateral anal sphincterotomy, the polyps or papillae were removed using a radio frequency device. A comparison before and after removal of the papillae or polyps was carried out for the associated complaints such as like pruritus, pricking sensation, wetness, crawling in the anus etc. In a separated randomized and prospective study, 80 patients were divided into two groups. 40 patients underwent only sphincterotomy, while in the remaining 40 patients, the papillae or polyps were removed after sphincterotomy. Symptom comparison was made before and after the procedure at 6- month follow-up.


RESULTS
After one month of the procedure, the associated symptoms were significantly reduced, with a near total decline in the primary complaints of pain and bleeding. There was significant reduction in conditions like pruritus (p=0.0001), discharge per anus (p=0.0001), crawling sensation in the anus (p= 0.0006) and sense of incomplete evacuation (p= 0.0001). The prospective study confirmed the above findings.


CONCLUSIONS
The above study establishes that removal of hypertrophied anal papillae and fibrous polyps should be routinely carried out during surgical treatment of anal fissure to add to effectiveness and completeness of the procedure.
Gupta
Pravin J
PJ
Gupta Nursing Home, D/9 Laxminagar, Nagpur-440022, India. drpjg_ngp@sancharnet.in
D001003:Anal Canal / Q000473:pathology* / Q000601:surgery*; D002908:Chronic Disease; D004564:Electrocoagulation; D005260:Female; D005401:Fissure in Ano / Q000150:complications / Q000601:surgery*; D006801:Humans; D006984:Hypertrophy / Q000209:etiology / Q000601:surgery; D008297:Male; D011127:Polyps / Q000209:etiology / Q000601:surgery*