Transperineal ultrasound in the assessment of haemorrhoids and haemorrhoidectomy: a pilot study.
BACKGROUND
The purpose of the study was the measurement of the anal cushion area using static transperineal ultrasound in a group of patients with symptomatic grade III and IV haemorrhoids about to undergo haemorrhoidectomy and compare them with a group of age-matched normals and the measured area following haemorrhoidectomy.


METHODS
Transperineal sonography was performed using a linear transducer measuring the anal cushion area by subtracting the measured luminal diameter of the undisturbed anal canal from the inner border of the internal anal sphincter. Measures were made 6 weeks following haemorrhoidectomy.


RESULTS
Comparisons were made between 22 normals and 36 patients with haemorrhoids (31 evaluable post-operatively). The median area of normals was 0.78 cm², that of pre-operative patients 2.25 cm² and that of post-operative cases 1.20 cm². There was a significant difference between pre- and post-operative cases with cushion areas of normal patients being significantly lower than post-operative cases. Variance of measurement in all 3 groups was negligible.


CONCLUSIONS
Static transperineal sonography measuring the anal cushion area is reproducible and shows marked differences between normals and patients with symptomatic haemorrhoids. There is a marked effect on measured area resultant from haemorrhoidectomy.
Zbar
A P
AP
Department of Surgery, Tamworth Rural Referral Centre, Universities of New England and Newcastle, PO Box 2064, Tamworth, NSW 2340, Australia. azbar55@yahoo.com
Murison
R
R
D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000000981:diagnostic imaging* / Q000473:pathology*; D006484:Hemorrhoids / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007413:Intestinal Mucosa / Q000000981:diagnostic imaging / Q000473:pathology; D008875:Middle Aged; D010502:Perineum; D010865:Pilot Projects; D014463:Ultrasonography
Proc R Soc Med. 1954 Nov;47(11):997-8
13215553
Acta Obstet Gynecol Scand. 2008;87(6):675-81
18568468
Minerva Chir. 2006 Apr;61(2):119-24
16871143
Dis Colon Rectum. 1998 Feb;41(2):200-8
9556245
Eur Radiol. 2001;11(7):1165-70
11471606
Dis Colon Rectum. 1980 Apr;23(3):160-9
7379669
Dis Colon Rectum. 1994 Dec;37(12):1296-9
7995162
Acad Radiol. 1995 May;2(5):385-91
9419580
Int J Colorectal Dis. 1991 Feb;6(1):2-4
2033348
Int J Colorectal Dis. 2004 Jan;19(1):60-7
12761642
Colorectal Dis. 2008 Sep;10(7):694-700
18294262
Tech Coloproctol. 2005 Jul;9(2):163-5
16007353
Int J Colorectal Dis. 1999 Nov;14(4-5):245-9
10647634
Dis Colon Rectum. 2002 Feb;45(2):239-45; discussion 245-8
11852339
Dis Colon Rectum. 2006 Sep;49(9):1410-3
16729219
Lancet. 1986 Apr 19;1(8486):886-8
2870357
Mech Chem Biosyst. 2004 Sep;1(3):191-9
16783932
Postgrad Med J. 1979 Jun;55(644):403-5
482185
Dis Colon Rectum. 2000 Nov;43(11):1572-4
11089595
Br J Surg. 1975 Jul;62(7):542-52
1174785
Br J Surg. 2009 Jun;96(6):680-4
19384910
Langenbecks Arch Klin Chir Ver Dtsch Z Chir. 1962;299:302-12
13916799
Colorectal Dis. 2004 Jul;6(4):226-32
15206963
Dis Colon Rectum. 2001 Nov;44(11):1610-9; discussion 1619-23
11711732
Br J Surg. 2009 Nov;96(11):1373-4; author reply 1374
19847853
Arch Fr Mal App Dig. 1976 Oct-Nov;65(7):501-14
1021002
Am J Physiol Gastrointest Liver Physiol. 2003 May;284(5):G748-55
12540368
Int J Colorectal Dis. 2009 Jan;24(1):105-13
18766355