ANAL STRICTURE FOLLOWING HEMORRHOIDECTOMY - EARLY DIAGNOSIS AND TREATMENT

Anal stricture is an uncommon but well recognized complication followi ng haemorrhoidectomy. Twenty-seven (3.8%) out of 704 (500 elective and 204 emergency) cases of haemorrhoidectomy performed at the Singapore General Hospital over a 24 month period had clinical evidence of anal stricture post-haemorrhoidectomy. Of the 27 cases, 15 had haemorrhoide ctomy as an elective procedure while 12 had it performed as an emergen cy procedure (X(2) = 3.26, 1 d.f., P > 0.05, not significant). The mea n interval between surgery and presentation of anal stricture was 6 we eks (range 3-12 weeks). Eighteen of the patients were managed by anal dilatation in the outpatient clinic combined with hulk laxatives and a local anaesthetic agent. The other nine patients required a minor sur gical procedure comprising either a lateral internal sphincterotomy (f ive) or an anoplasty (four) procedure. All patients were well, followi ng treatment. None of these patients developed a recurrent stricture a t follow up 3 months after treatment. It was concluded that although a nal stricture following haemorrhoidectomy is rare, it should be detect ed and treated early in order to avoid pain and suffering, and treatme nt is usually successful.