This protocol addresses chronic anal fissure in patients who regularly engage in receptive anal intercourse — a clinical subpopulation in which the choice of treatment approach requires specific consideration before any intervention is undertaken.
Patients with chronic anal fissure who regularly engage in receptive anal intercourse may be considered for conservative treatment algorithms and sphincter-preserving approaches. The anatomical and physiological characteristics of this group directly inform how assessment and management are structured.
Management follows a conservative, sphincter-preserving strategy. Sphincter pressure measurement and structural assessment are undertaken before any treatment begins. Biofeedback therapy is among the options that may be considered depending on individual findings — the complete structured regimen, including the full sequence of interventions, is available in the full protocol.
DOI: 10.1111/codi.167
Patients with regular receptive anal intercourse and chronic anal fissures may be considered for conservative treatment algorithms and sphincter preserving surgery.
A conservative sphincter preserving approach can be considered.
Biofeedback therapy or sphincter preserving surgery may be more appropriate.
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