**Figure 8.**

*In the spasm-controlled technique, anal calibrations are measured before and after sphincterotomy. a) Small anal calibrator is measured as 5–15 mm, b) anal caliber is measured about 12 mm in this patient with chronic anal fissure.*

apex sphincterotomy [65]. The spasm-controlled technique was performed by small serial sphincterotomies using an anal calibrator to achieve a 25–30 mm anal caliber, while fissure apex sphincterotomy was performed in a traditional way (**Figure 7**). Not surprisingly, the incontinence rates have been found significantly lower with described technique, and there was no significant difference in treatment failure (**Figure 8**).
