**12.1 Anal dilatation**

First described in 1829 by Recamier and popularized by Lord in the treatment of hemorrhoids, anal stretching has been used in the past based on the concept of loosening the sphincter muscle and increasing the blood flow to the anoderm. Anal dilatation was reintroduced for anal fissure therapy in 1964, with success rates of 87% to 100% (Watts et al., 1964), but are not recommended in children because of the very high rate of recurrence (10% - 30%) , risk of sphincter damage and incontinence after excessive stretching.
