A New Instrumental Procedure for Non-Prolapsing Hemorrhoidal Disease

Radiofrequency ablation (RFA) is a new approach for treating Grades I and II hemorrhoids. In this procedure, the hemorrhoidal tissue is exposed to high frequency radio wave to produce coagulative necrosis and fixation of the vascular components of the hemorrhoids. This study reports the author's experience with this technique. The aim of this study was to determine the efficacy of RFA in the treatment of Grades I and II hemorrhoidal disease. The present retrospective study reviews the early and long-term effects of radiofrequency ablation. A separate prospective and randomized study compared the results of radiofrequency ablation and rubber band ligation (RBL) in 60 patients with Grade II hemorrhoids in terms of their effectiveness and patient comfort. Two hundred and forty patients with Grades I and II bleeding hemorrhoids were studied. Ellman radiofrequency generator was used for this procedure. Fisher's test was carried out for the statistical analysis of the outcome of the prospective study.
Twenty three patients reported recurrence of bleeding, and 29 complained of pain or discomfort. The comparative study showed that though rubber band ligation was a more effective procedure (p<0.001), the rate and severity of pain was higher (p<0.001) than the radiofrequency coagulation. It is therefore concluded that radiofrequency ablation of hemorrhoids is easy to perform, is less painful, and has low rate of complications. It is better tolerated than RBL and can safely be repeated in case of recurrence of symptoms. It is however less efficacious.