English

Abstract

BACKGROUND: This study was carried out to evaluate possible differences of pre and post treatment parameters between patients undergoing injection Sclerotherapy, rubber band ligation and hemorrhoidectomy. METHODS: The prospective study was carried out in 150 patients of haemorrhoids during August 2010 to November 2012. Each group of 50 patients treated with injection sclerotherapy, band ligation and haemorrhoidectomy and followed up for 1 year for complications. RESULTS: In the present study pain, bleeding and urinary retention were common following haemorrhoidectomy. One patient had anal incontinence post sclerotherapy. Anal incontinence was found to be a major problem in post haemorrhoidectomy period. Two patients had anal stenosis after haemorrhoidectomy. Second setting required in 6 patients of sclerotherapy and 4 patients of rubber band ligation. No recurrence noted in haemorrhoidectomy patients. Following sclerotherapy, 35 (70%) patients resolved, 9 (18%) improved and 3 (6%) remained unchanged. Following rubber band ligation, 32 (64%) resolved, 12 (24%) improved and 3 (6%) unchanged, while after haemorrhoidectomy, 37 (74%) resolved and 10 (20%) improved. DISCUSSION: Injection sclerotherapy remains the choice in first degree haemorrhoids. Rubber band ligation can be considered as first line of treatment for second degree haemorrhoids and few cases of third degree haemorrhoid. Conservative methods are acceptable to patients in outcome and in patient compliance, but repetitions of treatment may be needed. Haemorrhoidectomy remains the only form of therapy with lasting results. Thus it should be considered for all cases of third and fourth degree haemorrhoids and for uncontrollable symptomatic recurrences following conservative procedures.