Efficacy and safety of sclerotherapy with polidocanol foam in comparison with fluid sclerosant in the treatment of first-grade haemorrhoidal disease: a randomised, controlled, single-blind, multicentre trial

Moser, Karl-Heinz; Mösch, Christoph; Walgenbach, Maren; Bussen, D.; Kirsch, Jan; Joós, A; Gliem, Petra; Sauerland, Stefan

doi:10.1007/s00384-013-1729-2

Cited by 62 publications

(75 citation statements)

References 18 publications

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“…More than 10 years ago, we begun using polidocanol 2% foam, which results from the mixture of liquid with air, changing drug characteristics with more sclerosing capacity and adherence to the endothelium with the same safety profile, but there is only one import study of its use and only on first-grade hemorrhoidal disease [18,19]. We learned with vascular surgery that used it regularly.…”

Section: Introductionmentioning

confidence: 99%

Polidocanol Foam Injected at High Doses with Intravenous Needle: The (Almost) Perfect Treatment of Symptomatic Internal Hemorrhoids

Fernandes

Fonseca

2018

GE Port J Gastroenterol

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Background and Aims: Hemorrhoid disorders are common. This study aimed to assess the efficacy and safety of polidocanol foam injected at high doses with intravenous needle for the treatment of symptomatic internal hemorrhoids that prolapse or bleed. Methods: We evaluated 2,000 consecutive patients with prolapsed hemorrhoids (grades II/III/IV) recruited over 6 years. Foam injection was performed in one to four sessions with polidocanol 2%: 10 mL of the mixture (2 mL liquid plus air) or 20 mL (4 mL liquid plus air). The number of sessions and amount of foam injected depended on initial hemorrhoid size, compliance to receive foam, and clinical response. The mixture, prepared using a three-way tap connected to two 10/20-mL syringes, was injected immediately after preparation using an intravenous needle. The primary endpoint was self-reported satisfaction without major complications at 4 weeks. Results: Efficacy was very high, with 1,957 patients (98%) reporting satisfaction regarding blood loss control and prolapse reduction. The procedure was well tolerated: 1,838 patients (92%) presented mild/no pain. Objective reduction of prolapse volume was documented in 86% of reobserved cases. Complications were rare and usually minor: only 3 cases of clinically significant bleeding (0.15%), 2 of whom were on dual antiplatelet therapy plus oral anticoagulation, 2 cases of rectal abscess, 8 hemorrhoid thromboses, and 1 urinary retention requiring catheter (0.7% severe complications). Conclusions: Treatment of internal hemorrhoids with polidocanol foam injected in high doses is very effective and safe for the control of blood loss and prolapse, even for patients on anticoagulation/antiplatelet treatment.

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Section: Introductionmentioning

confidence: 99%

Polidocanol Foam Injected at High Doses with Intravenous Needle: The (Almost) Perfect Treatment of Symptomatic Internal Hemorrhoids

Fernandes

Fonseca

2018

GE Port J Gastroenterol

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“…The only prospective study that sufficiently related about III and IV degrees revealed 70% of subjective moderate/excellent improvement. Patients submitted to IS have a relatively low occurrence of post-procedural pain: 36% in I degree is reported by Moser, 49% is reported by Takano (36,41). Bleeding is a very rare harm.…”

Section: Discussionmentioning

confidence: 89%

“…Patients submitted to IS have a relatively low occurrence of post-procedural pain: 36% in I degree is reported by Moser, 49% is reported by Takano (36,41).…”

Section: Resultsmentioning

confidence: 96%

“…However, the RCTs presented in literature are poor of data. A subjective excellent improvement is reported by Yuksel in 51% of patients with I and II degrees of hemorrhoids and in 80% of patients with I degree by Moser (37,41). The only prospective study that sufficiently related about III and IV degrees revealed 70% of subjective moderate/excellent improvement.…”

Section: Discussionmentioning

confidence: 94%

“…A subjective excellent improvement is reported in 80% of patients with I degree by Moser (41). Recurrence rates are shown in Table 11.…”

Section: @ C I C E D I Z I O N I I N T E R N a Z I O N A L Imentioning

confidence: 96%

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The non-surgical management for hemorrhoidal disease. A systematic review

Cocorullo¹

2017

GHIR

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IntroductionRationale. The non-surgical treatments for hemorrhoids include rubber band ligation (RBL), injection sclerotherapy (IS), infrared coagulation (IRC), anal stretch, cryosurgery, laser hemorroidectomy. These treatments are usually performed in outpatient clinics without anesthesia, so reducing the costs related to hospital stay, operation-theatre and anesthesia; moreover, these techniques are time-saving and allow preserving patients' working days. These procedures have found a large use in patients suffering bleeding and prolapse caused by early hemorrhoidal stages that did not found an improvement with conservative therapy.Objectives. The aim of this review is to provide a framework to select the best procedure for different patients in order to minimize complications and to obtain the cure for this widespread social problem. Among the treatments RBL, IS and IRC are the most utilized and were analyzed. It was analyzed: 1) Does these procedures help? 2) What are the common harms? 3) What are the rare harms? 4) How many are the recurrences? MethodsThis systematic review was undertaken in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines (2).Eligibility criteria. Studies on patient complaining of bleeding or prolapse due to hemorroidal disease managed with RBL, IS and IRC were collected. The hemorroidal degrees and the presence of bleeding or prolapses were analyzed. The well-defined treatment modality and the symptoms resolution as outcome measures were The non-surgical treatments for hemorrhoids are cost and time-saving techniques usually performed in patients suffering early hemorrhoidal disease. The most used are rubber band ligation (RBL), injection sclerotherapy (IS), and infrared coagulation (IRC

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Comparison of Ultrasound‐Guided Percutaneous Polidocanol Injection Versus Percutaneous Ethanol Injection for Treatment of Benign Cystic Thyroid Nodules

Gong

Wang

et al. 2017

J of Ultrasound Medicine

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Efficacy and safety of sclerotherapy with polidocanol foam in comparison with fluid sclerosant in the treatment of first-grade haemorrhoidal disease: a randomised, controlled, single-blind, multicentre trial

Cited by 62 publications

References 18 publications

Polidocanol Foam Injected at High Doses with Intravenous Needle: The (Almost) Perfect Treatment of Symptomatic Internal Hemorrhoids

Polidocanol Foam Injected at High Doses with Intravenous Needle: The (Almost) Perfect Treatment of Symptomatic Internal Hemorrhoids

The non-surgical management for hemorrhoidal disease. A systematic review

Comparison of Ultrasound‐Guided Percutaneous Polidocanol Injection Versus Percutaneous Ethanol Injection for Treatment of Benign Cystic Thyroid Nodules

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