Abstract
Background
Anal fissures can cause morbidity in an otherwise healthy young patient. The process of evacuation results in stretching and descent of the anoderm and perineum especially posteriorly. Posterior perineal support may provide counter pressure at the posterior aspect of the pelvic floor, balancing the pressure exerted by the faeces on the anal wall, thus improving evacuation and reducing the trauma associated with it, and reducing symptoms of anal fissures. Symptoms of constipation may also be reduced secondarily. We report the preliminary results with a novel, simple and noninvasive method of treatment provided by a toilet seat device.
Methods
A prospective study was performed in 32 patients. The study was designed mainly to investigate the patients’ subjective perceptions of their symptoms related to anal fissures and constipation. Questionnaires were provided to patients before, during and after treatment.
Results
The study revealed statistically significant improvement in pain, bleeding, symptoms of constipation and abdominal discomfort after 3 months usage of the device. The odds of patients perceiving an improvement in symptoms were also significantly increased after 3 months of treatment compared to 2 weeks of treatment.
Conclusion
This preliminary study revealed that a posterior perineal support device can bring about sig nificant improvement in the symptoms of patients with anal fissures. There may also be secondary benefits of a reduction in the symptoms of constipation. Although not conclusive, these results should serve as a springboard for further research into this area.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Lund JN, Scholefield JH (1996) Aetiology and treatment of anal fissure. Br J Surg 83:1335–1344
Kua KB, Kocher HM, Kelkar A, Patel AG (2001) Effect of topical glyceryl trinitrate on anodermal blood flow in patients with chronic anal fissures. A N Z J Surg 71:548–550
Maria G, Brisinda G (2000) Nonoperative management of chronic anal fissure. Dis Colon Rectum 43:721–726
Pascual M, Pera M, Courtier R et al (2007) Endosonographic and manometric evaluation of internal anal sphincter in patients with chronic anal fissure and its correlation with clinical outcome after topical glyceryl trinitrate therapy. Int J Colorectal Dis 22:963–967
Madalinski M (2008) Pascual’s study may change a mechanical point of view for anal fissure healing. Int J Colorectal Dis 23:555
Shafik A, Shafik AA, Shafik I, El-Sibai O (2006) Study of the role of the transverse perineal muscles during rectal filling. Int J Colorectal Dis 21:698–704
Klingele CJ, Bharucha AE, Fletcher JG et al (2005) Pelvic organ prolapse in defecatory disorders. Obstet Gynecol 106:315–320
D’Hoore A, Penninckx F (2003) Obstructed defecation. Colorectal Dis 5:280–287
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Tan, KY., Seow-Choen, F., Hai, C.H. et al. Posterior perineal support as treatment for anal fissures — preliminary results with a new toilet seat device. Tech Coloproctol 13, 11–15 (2009). https://doi.org/10.1007/s10151-009-0453-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10151-009-0453-y