Survey of methods of treatment of haemorrhoids and complications of injection sclerotherapy

Introduction: This study was conducted to survey current practices in the t reatment of haemorrhoids (Hs), prevalence of complications associated with injection sclerotherapy (IS) and attitudes to its use to treat anterior Hs. Methods: Postal questionnaires were sent to 92 consultant surgeons in the S outh East Thames Region. They were returned anonymously. Results: Seventy questionnaires were returned (76% response rate) and 61 qu estionnaires were used in the data analysis; 18 from coloproctologists and 43 from non-coloproctologists who treated Hs. First degree Hs were mostly t reated with IS alone (76%). Second degree Hs were treated with rubber band ligation (RBL) alone (36%) or a combination of IS and RBL (36%). Third degr ee Hs were mostly treated with haemorrhoidectomy (76%). Nineteen surgeons ( 31%) reported complications using IS; 82% of these were urological. Nine su rgeons (15%) did not use IS to treat anterior Hs and 10 (16%) advised their trainees not to inject anteriorly. Conclusions: IS is a common treatment of Hs. Nearly one-third of consultant s reported complications, the majority of which were urological and likely to be secondary to IS of anterior Hs. It may be safer to avoid IS of anteri or haemorrhoids.