Document Detail


Management of hemorrhoidal disease in patients with chronic spinal cord injury.
MedLine Citation:
PMID:  12077636     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Hemorrhoidal disease is a common pathology in patients with chronic spinal cord injury (SCI). We describe our experience with the primary approach to this problem at the Proctology Division of the Sheba Medical Center. We treated 29 patients (26 men) with paraplegia due to SCI between 1995 and 1999. The mean age was 49 years (range, 22-74 years). All patients had hemorrhoids in stages ranging between II and IV. Main complaints were rectal bleeding (83%), difficulties in evacuation (38%) and discomfort or pain (28%). Eleven patients (38%) were treated conservatively (e. g. diet, hygiene and laxatives), while 18 patients (62%) underwent either banding or sclerotherapy of hemorrhoids or both. No major complication were observed. In 28 of 29 patients (96%), there was a significant reduction or cessation of bleeding and/or relief of symptoms; one patient (3%) required hemorrhoidectomy. Of the 28 successful treatments, 16 (57%) had partial reduction of bleeding or relief of symptoms, while in 12 (43%) response was complete. Of those who were treated conservatively, 9 (82%) had partial and 2 (18%) had complete relief of symptoms. Of those who had banding/sclerotherapy, 7 (41%) had partial and 10 (59%) had complete relief. We also examined the effect of perianal sensation on the treatment outcome. Of 16 patients with complete anesthesia, 11 (69%) had partial and 5 (31%) had complete relief, whereas of the 12 patients with preserved sensation, 5 (42%) had partial and 7 (58%) had complete relief. In conclusion, the approach of banding or sclerotherapy of hemorrhoids in SCI patients is safe and effective. When sensation of the perianal region is preserved, the outcome seems to be better. The cause of SCI has no impact on the treatment results. There was no difference in the outcome of treatment between patients with stage II and stage III hemorrhoids; patients with stage IV hemorrhoids seem to do worse than those with stages II and III.
Authors:
D Scott; M Z Papa; M Sareli; A Velano; G Y Ben-Ari; M Koller
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Techniques in coloproctology     Volume:  6     ISSN:  1123-6337     ISO Abbreviation:  Tech Coloproctol     Publication Date:  2002 Apr 
Date Detail:
Created Date:  2002-06-21     Completed Date:  2002-09-16     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9613614     Medline TA:  Tech Coloproctol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  19-22     Citation Subset:  IM    
Affiliation:
Division of Proctology, Department of Surgical Oncology, The Sheba Medical Center, Tel Aviv University Medical School, Tel Hashomer, Ramat Gan, Israel. danscott@netvision.net.il
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Chronic Disease
Female
Hemorrhoids / etiology,  therapy*
Humans
Male
Middle Aged
Paraplegia / etiology
Spinal Cord Injuries / complications*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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