Injection sclerotherapy versus electrocoagulation in the management outcome of early haemorrhoids.
OBJECTIVE
To study the symptomatology of early hemorrhoids and to compare injection sclerotherapy (IS) with electrocoagulation (EC) in the management outcome of early haemorrhoids with respect to pain during the procedure, reduction in bleeding per rectum, and overall patient satisfaction score.


METHODS
A total of 102 patients were included in this experimental study at the POF Hospital, Wah Cantt from October 2004 to June 2005. A detailed history was taken and proctoscopic examination was performed. Patients were then randomly divided into two groups (Lottery method). One group was subjected to EC and the other to IS. In the EC, using the EC machine (Wieda, China), direct current of 10-20 mA was applied in the submucosal plane of each pile core for 5-7 minutes. In the IS 1-2 ml of 5% phenol in almond oil was injected in the same plane in each pile core. Pain during the procedure, reduction in bleeding per rectum and overall patient satisfaction, were studied as outcome measures.


RESULTS
The mean age of the patients was 44 years, 86 were males and 16 were females. Two thirds of the patients were having symptoms for more than 6 months. A third of patients had associated local pain while another third had associated mucous discharge. Chronic constipation was present in 81% patients. Only 24.5% of the patients had a positive family history of haemorrhoids. Patients in the electrocoagulation (EC) group experienced more pain during the procedure than the injection sclerotherapy (IS) group (P < 0.000), but EC was significantly more effective than IS in terms of reducing the bleeding per rectum (P = 0.039), and also significantly higher number of patients were fully satisfied with EC than with IS (P < 0.04).


CONCLUSIONS
EC, although more painful, is a safe, more effective and a highly satisfying procedure for treating early hemorrhoids.
Khan
Nasir
N
Surgical Unit I, POF Hospital, Wah Cantt, District Rawalpindi, Pakistan.
Malik
Muzaffar Ali Nasir
MA
D000328:Adult; D004564:Electrocoagulation; D005260:Female; D006484:Hemorrhoids / Q000628:therapy*; D006801:Humans; D008297:Male; D015911:Sclerotherapy