 Hypertrophied anal papillae and fibrous anal polyps: should they be removed during anal fissure surgery?

Abstract

Objective:  The present study is aimed to establish that
hypertrophied anal papillae and fibrous anal polyps can
cause symptoms and could cause concern to the
patients and that these should be removed while
dealing with patients of chronic fissure in ano.
Method: Two groups of patients were studied. One-hundred patients were studied in Group A where the
associated fibrous polyp or papillae were removed by
radio frequency surgical device after performing a
lateral subcutaneous sphincterotomy for relieving the
sphincter spasm. Another group of one-hundred
patients who also had papillae or fibrous polyps, were
treated by lateral sphincterotomy alone. They were
followed up to one year to assess their complaints.
Results: 89% patients from Group A expressed their
satisfaction with the treatment in comparison to only
64% from Group B who underwent sphincterotomy
alone with the papillae or anal polyps left untreated.
Group A patients showed a marked reduction with
regard to pain and irritation during defecation
(p=0.0011), pricking or foreign body sensation in the
anus (p=0.0006) and pruritus or wetness around the
anal verge (p=0.0008).
Conclusion: Hypertrophied anal papillae and fibrous
anal polyps should be removed during treatment of
chronic anal fissure. This would add to effectiveness
and completeness of the procedure.
Key words: Hypertrophied anal papillae, fibrous anal
polyps, radio frequency surgery, fissure-in-ano,
sphincterotomy

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