International Journal of Collaborative Research on Internal Medicine & Public Health

Effectiveness of Internal Sphincterotomy in reducing Post Open Hemorrhoidectomy Pain: A Randomized Comparative Clinical Study

Background: Hemorrhoids are one of the most common disorders of anus. Various treatment modalities have been described over the periods. However, open hemorrhoidectomy; mainly for grade 3 and 4 haemorrhoids is still widely used. The main drawback of hemorrhoidectomy is the pain in the early postoperative period. Studies have showed that internal Sphincterotomy along with Hemorrhoidectomy significantly reduces the post operative pain without any major complications.

Aim & Objective: The aim of this study was to evaluate the effects of internal Sphincterotomy in reduction of post open hemorrhoidectomy pain.

Methods: Over a period of two years 50 patients (38 male, 12 female) aged between 24 & 50 years) treated for 3rd and 4th degree haemorrhoids were included in this prospective randomised study. Patients were randomly divided in to two equal groups. Group I (control group) were subjected to classical open hemorrhoidectomy and group II (study group) were subjected to classical open hemorrhoidectomy with internal Sphincterotomy. Patients above 50 years of age and any patients associated with other colo-rectal or anal diseases were not included in our study.

Results: Mean post-operative pain score in study group (Gr- II) was 1.60 and in control group (Gr- I) it was 2.32 (P<0.01). Postoperative complications, like urinary retention was seen in 8 patients from Gr-I and in 1 patient from Gr-II. From Gr-II; as late complications, faecal soiling was present for 3 weeks in 1 patient and impaired control of flatus was present in 2 patients for 7-10 days. One patient from Gr-I developed anal stenosis which was managed conservatively.

Conclusion: Addition of Internal sphincterotomy to open hemorrhoidectomy is an effective method to reduce post open hemorrhoidectomy pain without significant morbidity.

Author(s): DK Das , UC Choudhury , Lim ZS

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