Is the severe pain after Milligan-Morgan hemorrhoidectomy still currently remaining a major postoperative problem despite being one of the oldest surgical techniques described? A case series of 117 consecutive patients

Medina-Gallardo, Adrian; Curbelo-Peña, Yuhamy; Castro, Xavier De; Roura-Poch, Pere; Roca-Closa, Josep; Caralt-Mestres, Enric De

doi:10.1016/j.ijscr.2016.11.018

Cited by 45 publications

(42 citation statements)

References 18 publications

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“…In our study, postoperative pain was the major drawback of hemorrhoidectomy early postoperative which scored mild to moderate and recorded in 21 patients (25.60%) in similar to others. [14] Postoperative urinary retention occurred in 6 patients (7.31%); four of them were elderly patients with mild BPH (66.6%). Mild bleeding per rectum was observed in 8.53% cases on the postoperative day 1 and delayed bleeding was noted in three patients (3.65%).…”

Section: Discussionmentioning

confidence: 99%

The impact of surgical hemorrhoidectomy on male sexual function: A preliminary study

2019

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Introduction: Erectile dysfunction (ED) is a highly prevalent condition among men all over the world and commonly associated with undiagnosed medical diseases as chronic pelvic pain and hemorrhoid. Objective: The purpose of this study was to study the impact of surgical hemorrhoidectomy on sexual function in men with erectile dysfunction (ED). Materials and Methods: In a prospective manner, we studied the effect of surgical hemorrhoidectomy on erectile function (EF) in male patients with ED. Hemorrhoidectomy was carried out in 82 patients with clinical hemorrhoid associated with ED (Group 1) and compared with 81 patients without operative intervention (Group 2; control). The primary efficacy variable was the mean change in the International Index of Erectile Function (IIEF) questionnaire. Results: In Group 1, the IIEF questionnaire increased significantly after hemorrhoidectomy, from 15.56 to 27.37 ( P < 0.001), indicating improvement of EF. Thirty-six patients (41.1%) showed improvement of EF compared to 5.3% in the control group ( P < 0.001). In Group I, but not in Group II, IIEF values increased significantly when compared with preoperative values ( P < 0.001). Conclusion: We concluded that surgical hemorrhoidectomy is clearly related to improvement of EF in male hemorrhoid patients with ED.

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Section: Discussionmentioning

confidence: 99%

The impact of surgical hemorrhoidectomy on male sexual function: A preliminary study

2019

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“…Namun akibat dari prosedur bedah hemoroidektomi tersebut, eksisi setelah operasi akan menimbulkan rasa nyeri yang hebat (Shenoy & Anitha, 2014). Seperti dalam jurnal yang menjelaskan bahwa nyeri klien post hemoroidektomi menjadi masalah besar, dan perlu mendapat pengelolaan yang lebih baik (Medina-Gallardo et al, 2017). Maka penatalaksanaan nyeri menjadi prioritas setelah operasi hemoroidektomi dilakukan.…”

Section: Pendahuluanunclassified

Studi Kasus: Upaya Penurunan Nyeri pada Klien Post Hemoroidektomi di RSK Ngesti Waluyo Parakan Temanggung

Ediyanto¹

2019

JurMedSur

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Hemoroid atau yang sering dikenal dengan penyakit wasir atau ambeien merupakan penyakit yang sangat umum terjadi di masyarakat dan sudah ada sejak jaman dahulu. Saat ini tindakan penyembuhan hemoroid yang menjadi gold standart adalah operasi hemoroidektomi. Namun nyeri post operasi hemoroidektomi masih menjadi masalah besar yang disebabkan oleh spasme perianal. Tujuan dari penulis dapat memahami asuhan keperawatan pada pasien dengan nyeri post hemoroidektomi dengan melaporkan tindakan nonfarmakologi terhadap penurunan nyeri. Metode yang digunakan penulis adalah metode deskriptif dengan pemaparan studi kasus melalui pendekatan asuhan keperawatan yakni pengkajian, penegakan diagnosa keperawatan, perencanaan, implementasi, dan evaluasi keperawatan. Tindakan keperawatan 3x24 jam yang dilakukan pada klien dengan post hemoroidektomi adalah mengajarkan teknik non- farmakologi untuk menurunkan nyeri yaitu menganjurkan klien untuk memilih posisi yang nyaman dan memberikan bantalan flotasi saat duduk, mengajarkan klien relaksasi nafas dalam, dan mengajarkan klien teknik distraksi. Masalah nyeri akut teratasi sebagian sehingga membutuhkan perawatan lebih lanjut dan kerjasama dengan tim medis lain, klien dan keluarga sangat diperlukan untuk keberhasilan asuhan keperawatan.

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“…Hemorrhoidal disease (HD) is the most common disorder of the anal canal [1, 2]. Clinical manifestation includes pain, bleeding, pruritus and prolapse.…”

Section: Introductionmentioning

confidence: 99%

“…Throughout the years, a variety of effective methods for treatment of hemorrhoids has been proposed but for grade II, refractory to conservative management, grade III and IV, and in cases of the recurrent disease, the conventional hemorrhoidectomy (CH) remains “the gold standard” [1–3]. However, it is still associated with significant postoperative pain and discomfort, requiring opioids in analgesic management in 20–40% of patients, and complications such as possible sphincter dysfunction, bleeding, infection, anal stenosis, and fecal incontinence [1–3]. In order to reduce them, a Doppler-guided transanal hemorrhoidal dearterilization (THD) has been introduced as an effective alternative since the 90’s [1–4].…”

Section: Introductionmentioning

confidence: 99%

“…However, it is still associated with significant postoperative pain and discomfort, requiring opioids in analgesic management in 20–40% of patients, and complications such as possible sphincter dysfunction, bleeding, infection, anal stenosis, and fecal incontinence [1–3]. In order to reduce them, a Doppler-guided transanal hemorrhoidal dearterilization (THD) has been introduced as an effective alternative since the 90’s [1–4]. There is an increasing number of studies comparing THD and CH, but the focus of most of them is the early postoperative results [5–7].…”

Section: Introductionmentioning

confidence: 99%

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Doppler-guided transanal hemorrhoidal dearterilization versus conventional hemorrhoidectomy for treatment of hemorrhoids – early and long-term postoperative results

et al. 2019

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BackgroundA variety of effective methods for treatment of hemorrhoids has been proposed. In recent years, there has been an increasing number of studies comparing transanal hemorrhoidal dearterilization (THD) and conventional hemorrhoidectomy (CH), but the focus of most studies has been about the early postoperative results. The data about long-term outcomes is still limited. We aimed to compare Doppler-guided THD and CH with regard to early and long-term postoperative results.MethodsThe conducted prospective research included 287 patients who underwent CH (167 cases) or Doppler-guided THD with mycopexy (120 patients) between November 2010 and December 2015. Information on hemorrhoidal stage, demographic data, presenting symptoms, complications, duration of hospital stay, postoperative pain, patients’ satisfaction and follow-up were obtained. Statistical tests were performed by SPSS 19.0.ResultsThere was no significant difference between the studied groups according to gender, mean age, preoperative prolapse, pain and pruritus, hemorrhoidal stage and postoperative complications. Preoperative bleeding was more frequent in THD group (p = 0,002). The mean visual analog scale (VAS) pain scores in CH and THD groups on days 1, 2 and 7 were 7.01 vs 5.03, 5.07 vs 2.98, 2.39 vs 0,57 (p = 0,000). Practically, there was no difference in VAS on day 30 and patients’ satisfaction at the 18th month. Mean hospital stay was 5,13 (CH) and 3,38 days (THD), p = 0,000. The postoperative follow-up was between 18 and 78 months (mean 46 ± 16 months). During this stage, 5 patients (2,99%) in CH group required surgery for recurrence. In THD group, 3 patients (2,5%), all with 4th-degree hemorrhoids underwent additional procedures (p 0,802).ConclusionsDoppler-guided THD seems to be an efficient and safe option for treatment of hemorrhoids, related to lower postoperative pain and excellent, similar long-term outcomes compared to CH. For advanced grades of hemorrhoids, Doppler-guided THD could be a valuable alternative, but there is a need for patients’ selection.Trial registration(retrospectively registered) researchregistry3090.

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Is the severe pain after Milligan-Morgan hemorrhoidectomy still currently remaining a major postoperative problem despite being one of the oldest surgical techniques described? A case series of 117 consecutive patients

Cited by 45 publications

References 18 publications

The impact of surgical hemorrhoidectomy on male sexual function: A preliminary study

The impact of surgical hemorrhoidectomy on male sexual function: A preliminary study

Studi Kasus: Upaya Penurunan Nyeri pada Klien Post Hemoroidektomi di RSK Ngesti Waluyo Parakan Temanggung

Doppler-guided transanal hemorrhoidal dearterilization versus conventional hemorrhoidectomy for treatment of hemorrhoids – early and long-term postoperative results

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