title: Hemorrhoidectomy and sphincterotomy. A prospective study comparing the effectiveness of anal stretch and sphincterotomy in reducing pain after hemorrhoidectomy.
abstract: The effectiveness of two maneuvers, anal stretch (group 1) and sphincterotomy (group 2), were evaluated in reducing posthemorrhoidectomy pain. The study included 133 patients in group 1 and 125 patients in group 2. Immediate follow-up results showed that 18.4 percent of patients in group 2 required narcotic analgesics in the first 24 hours as compared with 100 percent of group 1 patients (P less than .01). Urinary retention developed in 4 percent of the patients in group 2 and 39 percent of the patients in group 1 (P less than .01). Pain associated with the first postoperative motion was severe in 96.2 percent of those in group 1 as compared with 6.4 percent of patients from group 2 (P less than .01). Moreover, long-term follow-up showed that 57.3 percent of group 1 patients continued to suffer from fecal soiling for ten weeks as compared with 6.4 percent in group 2 who suffered only 4.5 weeks (P less than .01). The routine performance of sphincterotomy through one of the hemorrhoidectomy wounds significantly reduced posthemorrhoidectomy pain and complications.
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000601:surgery*; D000701:Analgesics, Opioid / Q000627:therapeutic use; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D008297:Male; D010149:Postoperative Pain / Q000517:prevention & control*; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D011897:Random Allocation; D013997:Time Factors; D014555:Urination Disorders / Q000209:etiology
chemical_list: D000701:Analgesics, Opioid