Sclerotherapy of hemorrhoids - more about the procedure
- Jun 19, 2018
Sclerotherapy of hemorrhoids is a relatively new method of treating hemorrhoids. In which cases it is applied and how it goes, this article will be discussed.
In the course of his evolution, a man has come a long way, and from a monkey climbing trees, he turned into a "homo sapiens" standing firmly on his feet. Developing and understanding the world, a man made his life more comfortable. Another leap of evolution led to the advent of television, the Internet and seated humanity in comfortable chairs and sofas. We are moving less and more and spend more time in the virtual space. The payment for a sedentary lifestyle becomes a disease that leads the list of "diseases of civilizations" - hemorrhoids.
Progress does not stand still and in recent years new methods of treating this disease appeared, alternative to conservative medical treatment. These are gentle minimally invasive procedures, one of which is the sclerotherapy method.
What is sclerotherapy for hemorrhoids?
What is sclerotherapy for hemorrhoids?
Sclerotherapy, or sclerotherapy, is a modern bloodless method of treatment aimed at removing the hemorrhoidal node by eliminating the blood flow that feeds it. The essence of the procedure is reduced to the introduction of a special drug substance - sclerosant - into the lumen of the node with the help of injection. This substance causes in the veins the development of the inflammatory process, the venous walls stick together and gradually overgrow.
Blood supply to the node stops and it dies. An interesting fact: it turns out that a similar procedure was used to treat hemorrhoids two centuries ago. That's only as sclerosing solutions introduced aggressive substances such as ethyl alcohol or a solution of carbolic acid. Currently, the procedure uses modern drugs that are well tolerated, do not harm the body and can achieve excellent results.
Indication for the procedure is chronic internal hemorrhoids of the 1st, 2nd stage. The best results are achieved when the nodes are still small. Much less often, this procedure is used in the third stage, since its effectiveness is significantly reduced as the hemorrhoidal node increases in size. At the 4th stage of hemorrhoids, the sclerotherapy method is used only as a preparation for the basic surgical treatment.
Advantages of the
- method Simplicity and safety. During the procedure, modern drugs are used that do not have a negative effect on the body.
- The procedure is painless. The drug is injected with the finest needles and the patient can normally feel only a slight burning sensation.
- Manipulation is carried out on an outpatient basis, there is no need to go to hospital. After the procedure, the patient can immediately return to the ordinary way of life.
- The sclerotherapy method can be successfully applied in the treatment of elderly patients who are contraindicated for other treatment methods due to the fragility and fragility of the vessels.
- The patient feels the positive effect of the procedure as soon as possible.
- In one session, several hemorrhoids can be treated at once.
- Treatment is inexpensive and is carried out in a rather short time.
- The procedure eliminates the consequences of the disease, without affecting its cause. Therefore, if the patient does not adjust the lifestyle, the likelihood of relapse is very high.
- The method is used only for the treatment of internal hemorrhoids. With external and combined form the procedure is ineffective.
- Sclerotherapy does not help with advanced forms of the disease and the presence of large hemorrhoids.
As with any other procedure, the sclerotherapy method has a number of contraindications:
- It can not be done with exacerbations of the disease, thrombosis, severe bleeding, and also when the patient suffers from anal fissures or fistulas.
- Absolute contraindication to the application of the method is the erosion of boundaries, that is, the absence of a clearly defined boundary between internal and external hemorrhoids( combined hemorrhoids).
- The procedure is not recommended for pregnant and lactating women and patients with an allergic reaction to sclerosing drugs.
How is sclerotherapy of hemorrhoids performed?
The procedure is not a surgical procedure, nevertheless, in order for the treatment to be successful, preliminary preparation is necessary. Proctologists recommend two hours before the beginning of a cleansing enema.
The patient assumes the position of "lying on his back," with his legs pressed to his stomach. This position is most convenient, both for the doctor and for the patient himself. In some, complicated cases, the knee-elbow position may be possible or the patient is located on its side.
Before starting the procedure, the doctor disinfects the area of exposure and applies a gel-anesthetic. For injections, a special syringe with the thinnest needle is used, as a result, during the injection the patient does not feel pain. To gain access to the internal hemorrhoids, an anoscope is inserted into the anal canal. A sclerosing drug is drawn into the syringe, then through the anoscope it is injected into the base of the hemorrhoidal node.
The drug enters the blood supply area of the selected nodes, an injection is made over the dentate line that separates the pain-insensitive cylindrical epithelium from the sensitive flat epithelium. If the patient feels pain during the injection, it is likely that the injection is being done incorrectly.
The needle should be inserted parallel to the anal canal to a depth of 2 cm. Sclerosing solution is injected slowly so that it is evenly distributed in the tissues. After the injection, the needle is not immediately removed, leaving in place for 1-2 minutes. This is done in order to reduce the possibility of bleeding and prevent leakage of the solution.
The healing solution causes inflammation in the walls of the vessels, they are glued together and gradually replaced by a connective tissue. Venous blood ceases to flow into the node, it dries up, dies and disappears after a while. The missing node is painlessly withdrawn during defecation.
After the sclerosing procedure, the patient spends about an hour under the supervision of a doctor to make sure that everything went well and in time to get help in the event of anxiety symptoms. Then he can go home and lead a habitual way of life. For 3 weeks, lifting of weights and prolonged physical activity are forbidden.
Some time after the procedure, there may be minor pain, which is removed with analgesics. After manipulation swelling quickly enough, discomfort and inflammation disappear in the area of the anus. Follow-up examinations are conducted two weeks after the intervention. In the course of his doctor-proctologist evaluates the results and decides whether continuation of treatment is necessary.
Patients note that, after the procedure, the nodes rapidly decrease in size, and significant relief comes. In order to achieve maximum effect and remove all the nodes, it is necessary to make several procedures, observing the interval between them in 7-10 days. This time is enough for restoration. Each time the manipulation will be carried out with different nodes and the more of them, the more often the patient will have to undergo repeated sessions before the complete cure.
Possible complications of sclerosing
Usually the procedure is fairly easy to tolerate, but in some cases complications may occur. This is due to the incorrect administration of the solution and the erroneous actions of the doctor. Therefore, before deciding to conduct manipulations, make sure that your doctor is qualified and experienced, ask the opinion of those who have already undergone this procedure. Among the possible complications are usually noted:
- Severe pain. The development of the pain syndrome indicates that the technique of the procedure was broken and the solution was administered incorrectly.
- Development of bleeding. The appearance of bleeding immediately after the injection testifies that the artery passing near the node was touched. This bleeding usually stops easily. Sometimes with too much dose of injecting the solution or getting into the mucous membrane, ulcers can form, which threatens the development of bleeding through a remote period of time.
- Sclerosing solution enters the vein. If during the procedure the patient feels an unpleasant taste in the mouth, pain in the liver, and the doctor notices that the solution is injected too easily, then the needle has got into the anal vein. In this case, the procedure must be stopped immediately.
- Sclerosant entering the prostate. Complications are noted in male patients suffering from prostate adenoma and having an enlarged prostate gland. In these cases, the nature of the complications can be quite serious. It depends on the amount of solution and on what department he hit. It can be a delay of urine, the development of prostatitis. In serious cases, the development of infertility or purulent inflammation is an abscess.
It should be noted that such serious complications are very rare, only 0.02% of cases and they are associated with violation of the rules of procedure.
How much does sclerotherapy for hemorrhoids cost? Today, the technique of treatment by this method is perfected, and the price of the procedure is available to almost any patient. We will quote the average prices for the treatment of one node in different cities:
Moscow - 3000-8000 rub. For one node
Kazan - from 3500 rubles. For one node
St. Petersburg - from 3000 to 6000 rubles. For one node
Patients' comments on the operation of sclerotherapy of hemorrhoid nodes
Review No. 1
The doctor recommended me a sclerotherapy procedure. I was diagnosed with stage 2 hemorrhoids. There was an internal node the size of a pea, hemorrhoids periodically exacerbated, the knot inflamed and hurt. The usual methods of treatment with candles and ointments gave temporary relief, then everything was repeated anew. Decided on the procedure and do not regret it.
All manipulations were carried out in a polyclinic and did not go to a hospital. The doctor was reliable and experienced. I'm afraid of pain, so before starting the procedure I was asked to anesthetize, an anesthetic gel was applied to me. During the prick of pain did not feel, it was a little unpleasant and there was a feeling of bursting and burning. The doctor said that this is normal. After 1.5 hours after the injection, they were released home.
In the first two days there were minor pains, saw analgesics, then everything went away. A few days later I felt a great relief, the knot greatly decreased, and then I completely ceased to feel it. I was warned that he would fall off and leave during a bowel movement with stool. Probably, it happened. The result is satisfied, I will follow the doctor's recommendations so that the recurrence of the disease does not happen.
Alexandra, 54 years - Moscow
I have several nodes. During the first session the doctor made an injection in two sites, the procedure was unpleasant for me, but there was almost no pain. Rather painfully hurted three days after, was saved by analgetics. Now it's better, in two weeks I will do a repeated injection, there is still one more node. I think it's worth to suffer, the result after the first injection is already noticeable, it's much better.
Михаил, 36 years - St. Petersburg