[Sphincter surgery. Etiology and therapy of the anal fissure (author's transl)]

Anal fissures belong to the autonomic diseases. A raised sympathicotonus (spasm dystrophy) is responsible for the origin, the poor healing tendency and the burning pain. This excessive effect of the sympathetic leads first to functional and later to organic disorders of the sphincter in the form of an achalasia. The empirically developed methods of operation have intervention in the autonomic nervous system in common, and only differ in the extent of this "invasion of the autonomic". Functional changes must be treated with local anesthetics or by stretching the sphincter, organic changes by sphincterotomy.