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The medical treatment of chronic anal fissure has multiple options. Tadalafil was hardly analyzed in the literature as a therapeutic option. Objective: To evaluate the safety and effectiveness of the use of topical Tadalafil for the medical treatment of anal fissure. Design: Observational non-randomized prospective study. Patients and methods: Patients with chronic anal fissure lasting more than 8 weeks treated with Tadalafil during the 20112018 period were analyzed. Those who did not complete treatment were excluded. Cure rate, adverse effects, treatment time and its relationship with response were recorded. Setting: Two private medical institutions. Results: Eighty-six patients, 53 men (61%), 77 of them older than 55 years, were analized. Cure was achieved by 82.5% of patients, 11.6% underwent surgery, and the remaining patients continue chronic medical treatment with a good clinical response. Seventy-two percent of patients had 2 months of treatment (p = 0.002); 7 patients, 3 months; 12, between 3 and 6 months; and 5, more than 6 months. Sixty-four percent of patients did not present previous anal pathology and the rest did not modify their results despite the association. No adverse was presented in 95% of patients and those reported (rush, thrombosis, light bleeding) were mild. Conclusion: Treatment with Tadalafil has a high cure rate and symptomatic resolution with almost no side effects. In failure cases surgery resolved the condition. The performance of other comparative studies with other pharmacological methods and/ or surgical treatment could affirm these results.

EFICACIA DEL USO DEL TADALAFILO TOPICO EN EL TRATAMIENTO DE LA FISURA ANAL Resultados de un estudio cooperativo