The investigation objective was to estimate the role of nontraumatic anal sphincter (AS) stretching, as a leading factor of success in minimally invasive and/or
plastic proctological interventions. One-centre randomized investigation was performed in 83 patients: In 22 of them the AS fissura was revealed (in 16), suprasphincteric
fistula (in 3) and coexistent
rectocele 2-3 Ap (according to POP-Q classification) with thinning of the AS anterior segment, the degree III
hemorrhoids and anterior AS fissure presence. Ninety units of botulotoxin preparation (Disport) were injected between internal and external AS portions 5-15 days preoperatively. The treatment results without botulotoxin injection were compared retrospectively. After botulotoxin injection performance the AS
spasm elimination was noted, leading to the
pain subsiding promotion before and postoperatively in all the patients observed. The
spasm elimination have permitted to escape the anal high
fistula recurrence as a result of the mucosal flap shift after intraluminal closure of the
fistula or because of the
fistula intermuscular electrowelding "
suture"
rupture, also have guaranteed the
plastic sutures on AS, even while the stage II-III
rectocele presence, not depending of performance of its simultant surgica correction.