Volume 14, Issue 2 (5-2011)
J Arak Uni Med Sci 2011, 14(2): 58-63 |
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abedi dost S, Poya M, shakouri M S. The effect of internal sphincterotomy on post hemorrhoidectomy pain . J Arak Uni Med Sci 2011; 14 (2) :58-63
URL: http://jams.arakmu.ac.ir/article-1-650-en.html
URL: http://jams.arakmu.ac.ir/article-1-650-en.html
1- azad university of tonekabon , s_a_422@yahoo.com
2- azad university of tonekabon
2- azad university of tonekabon
Abstract: (14144 Views)
Background: Hemorrhoidectomy is the basis of treatment for grades three and four hemorrhoid. One of the major post hemorrhoidectomy problems is pain that is usually due to the spasm of the internal sphincter. There are different methods for the management of postoperative hemorrhoidectomy pain. The aim of this study was to investigate the effect of sphincterotomy on post hemorrhoidectomy pain.
Materials and Methods: This interventional clinical trial was conducted on 60 patients with 3rd and 4th grade hemorrhoid who had randomly been divided into hemorrhoidectomy and hemorrhoidectomy combined with sphincterotomy groups. The degree of pain was measured on visual analogue scale (VAS) and analyzed through Mann-Whitney, Friedman, and Chi square tests via SPSS version 14.
Results: In terms of reduction in pain with sphincterotomy, there was a significant relationship between the two groups on the first, second, and fifth postoperative days (P=0.001). On the third and sixth postoperative days, a significant relationship was observed between the two groups (P=0.001). Days four and seven also indicated a significant relationship between the two groups (P=0.002). However, there were not any significant relationships between the two groups in terms of urinary and fecal incontinence and gas retention (P>0.05). A significant relationship existed between the two groups in terms of reduction in the need for sedation (P=0.006).
Conclusion: Lateral internal sphincterotomy combined with hemorrhoidectomy can reduce the patients’ post hemorrhoidectomy pain and can reduce the use of analgesics, but it does not have any significant influences on the incidence of urinary retention and bleeding after the first defecation and does not increase the risk of fecal and gas incontinence in comparison with the hemorrhoidectomy group.
Subject:
Surgery
Received: 2010/03/7
Received: 2010/03/7
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