5. Sclerotherapy of Hemorrhoieds

The indication, limitation and combination with other methods

Abstract

Most of hemorrhoids of moderate degree are able to be treated at out-patient services. However, some knowledges and experiences are demanded for the selection of patients in view of the indication, limitation, combination with other methods, safety and freedom from pain. For the past one year and 10 months, 149 cases of hemorrhoids were treated at our clinic with the combination of 5% phenol almond oil, . McGivney's hemoligator and trichlor acetate.
The effect of sclerotherapy is remarkable in I-and II-degree bleeding hemorrhoids. Submucous injection must be strictly observed for the prevention of necrosis of the mucosa, intravascular instillment, prostatitis and urethritis in male cases. The amdunt can be varied according to the size, prolapsing tendency and other factors. The effect of sclerotherapy is not necessarily permanent and in some cases bleeding recurs 3 to 12 months after the injection. In these cases, the injection is repeated. The indication of sclerotherapy is not limited to I- and II-degree hemorrhoids but also applied to some cases of III-degree hemorrhoids, prolapsing mucosa and fissure caused by prolapsing hemorrhoids.
The injection method is supplemented by ligation method with hemoligator, which is used for soft, fingertip-sized hemorrhoids of any degree. Remaining, small external hemorrhoids and skin tags are cauterized by trichlor acetate with mild sensation of hotness. Large, III-degree hemorroids combined with external hemorrhoids are operatively treated in the hospital.