Emerging treatments
Platelet-rich plasma
Two studies found that treatment with platelet-rich plasma (PRP) injection improved epithelialization and wound healing in patients with acute or chronic anal fissure.[29][30]
Potassium channel openers
Some potassium channel openers such as minoxidil also relax the internal sphincter, but none are generally recommended for use in this condition. One study found 0.5% topical minoxidil and 2% topical diltiazem were equally effective for treatment of chronic anal fissure.[31]
Transcutaneous electrical posterior tibial nerve stimulation
Several studies have evaluated the potential of transcutaneous electrical posterior tibial nerve stimulation versus lateral internal sphincterotomy as a definitive treatment for chronic anal fissure. However, one small randomized controlled trial suggests that surgical sphincterotomy is superior in both short- and medium-term outcomes.[32]
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