External validation of the REALISE score for assessing botulinum toxin injection efficacy in the treatment of chronic anal fissure.

This article discusses the external validation of the REALISE score, a scoring system used to assess the efficacy of botulinum toxin injection (BT) in the treatment of chronic anal fissure (CAF). The study included adult patients who received BT for CAF, excluding those with inflammatory bowel disease. The REALISE score, which measures pain intensity, impact on quality of life, duration of anal pain, frequency of analgesic intake, and anal bleeding, was calculated before and after BT. The study found that BT is a valid and safe treatment option for CAF, with a 3-month fissure healing rate of 68%. The REALISE score was shown to be reliable in assessing the severity of anal fissures, and a post-BT REALISE cutoff of 5 accurately identified patients without fissure healing. [Extracted from the article]