Long-term manometric study of anal sphincter function after hemorrhoidectomy

Patti, Rosalia; Almasio, Piero Luigi; Arcara, M; Sparacello, Massimiliano; Termine, Stefania; Bonventre, Sebastiano; Vita, Gaetano Di

doi:10.1007/s00384-006-0174-x

Cited by 19 publications

(10 citation statements)

References 22 publications

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“…Anal RP may decrease following haemorroidectomy. On the other hand RP is often higher than normal in patients with symptomatic haemorrhoids and recent studies have shown that although RP was decreased by surgery, it was not lower than in controls, 6 to 12 months after haemorroidectomy [38,39]. Thus, we do not believe that haemorrhoidectomy in a few patients influenced our results.…”

Section: Discussioncontrasting

confidence: 75%

Anorectal manovolumetry in the decision making before surgery for slow transit constipation

2007

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Section: Discussioncontrasting

confidence: 75%

Anorectal manovolumetry in the decision making before surgery for slow transit constipation

2007

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“…It is known that many patients with symptomatic hemorrhoids have elevated anal resting pressure [6][7][8][9][10]. The etiology of the hemorrhoid disease is unknown and still debated; however, the elevated anal resting pressure is considered as one of the etiological factors [11].…”

Section: Discussionmentioning

confidence: 99%

“…The etiology of the hemorrhoid disease is unknown and still debated; however, the elevated anal resting pressure is considered as one of the etiological factors [11]. It has been demonstrated that the increased resting pressure is reduced in the early period after haemorrhoidectomy [9,12]. There is ongoing debate as to whether the pressure decline following haemorrhoidectomy is due to removal of the hemorrhoid anal cushions or because of prolonged retraction of the anal canal [13].…”

Section: Discussionmentioning

confidence: 99%

Functional Activity of the Internal Anal Sphincter Following Haemorroidectomy. A Long-term Manometric Study

2010

Med. Con.

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Background: Haemorrhoidal disease is the most prevalent disorder of the anorectal region. It affects 4.4% of the western population and most of these patients are symptomatic and need treatment. The aim of this study was to evaluate long term results of the sphincter function following haemorrhoidectomy.Method: Between the years 2004-2007, 48 patients (28 females and 20 males) who underwent haemorrhoidectomy were included in the study. All patients had third or fourth degree symptomatic hemorrhoids and had three column Milligan-Morgan operation. Manometric studies were performed before surgery and repeated post-operatively at one, three, six and 12 months. A control group included 12 normal volunteers 5 women and 7 men. All the patients had a manometric evaluation using a 6 channel perfusion catheter.Results: Baseline manometric measurement in the hemorrhoids group was significantly higher than in the control group (108.4±23 mmHg vs. 73±5.9 mmHg, p<0.0001). Following surgery the pressure declined after 1 month to a level of 74.5±12.8 mmHg and rose gradually to 103.6±21.5 mmHg after 12 months. These levels were still significantly higher than those of the control group. ARTICOL ORIGINAL ORIGINAL ARTICLE Conclusion:The function of the internal anal sphincter is only temporarily disturbed but regains its strength gradually over one year. Longer anal retraction results in a greater decline in manometric values after 12 months.

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“…Studies have shown an elevation of MRP and ultra slow waves activity (USWA) in patients with haemorrhoids when compared with controls. 2 This is due to abnormal, hypertonicity of the internal anal sphincter. It is not clear if the high resting anal pressures are caused by haemorrhoids or whether they are the cause of the haemorrhoids themselves.…”

Section: Aetiologymentioning

confidence: 99%

“…Several studies have shown that the pressures in the internal anal sphincter is greatest after a patient has had haemorrhoidectomy. [2][3][4] This causes pain which leads to further increase in the pressure and so a vicious cycle ensues. There are other postulated mechanisms for experiencing post-operative pain after haemorrhoidectomy.…”

Section: Aetiologymentioning

confidence: 99%

A Brief Literature Review on the Management of Post-Haemorrhoidectomy Pain

Uzzaman

Siddiqui

2011

Surgical Techniques Development

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The most commonly encountered complication after haemorrhoidectomy is post-operative pain. Relief of this pain may aid earlier recovery. A literature search was performed examining the different surgical and medical agents for the relief of post haemorrhoidectomy pain using Pubmed, MEDLINE, EMBASE, CINAHL and Cochrane library databases. Pain can be relieved by surgical or medical agents. Surgery incorporates a risk of incontinence. A number of studies examine the role of medical agents.A variety of surgical techniques and medical agents are available to the clinician in the treatment of post haemorrhoidectomy pain. Tailored management to individual patients should ensure appropriate symptomatic control and prompt recovery.

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Long-term manometric study of anal sphincter function after hemorrhoidectomy

Abstract: Our data support that Milligan-Morgan hemorrhoidectomy induces a complete resolution of typical manometric alterations of disease and that the excision of anal cushions is responsible only for mild and transient alteration of anal continence.

Cited by 19 publications

References 22 publications

Anorectal manovolumetry in the decision making before surgery for slow transit constipation

Anorectal manovolumetry in the decision making before surgery for slow transit constipation

Functional Activity of the Internal Anal Sphincter Following Haemorroidectomy. A Long-term Manometric Study

A Brief Literature Review on the Management of Post-Haemorrhoidectomy Pain

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