Additionally, we used a questionnaire to register such indices as clinical signs and symptoms, staple-line bleeding requiring suture, distance of the staple line from the dentate line, length of the operation (from the beginning of anal dilatation
until the removal of traction sutures), and duration of the patients' disease.
or sphincter stretching that is Lord's dilatation upto 4 fingers.
Traditional surgical procedures; manual anal dilatation
or internal lateral sphincterotomy have been commonly used to reduce the hypertonia of the internal anal sphincter but they carry risk of permanent impairment of anal continence.
After the completion of the surgical anal exposition in the extrasphincteric plane, a ventral defect and muscular fibers weakness of the external anal sphincteric musculature were detected, which is thought to developed as a result of the excessive anal dilatation
performed in previous surgery.
After firmly traction, anal dilatation
was done and the foreign body was safely extracted with the aid of ring forceps through the anus without any complications.
After a complete assessment, we prepared the patient for gentle anal dilatation
under intravenous conscious sedation.
Nataraj in 1971 proposed internal sphincterotomy is an alternative of anal dilatation
The various modalities of treatment include Sclerosant injection therapy, Lord's procedure of anal dilatation
, cryotherapy, infrared coagulation, laser therapy, direct electro-cautery, bipolar coagulation and Rubber Band Ligation.
The present study shows that MMH leads to longer healing time than FH .In our series three patients (2.9%) with anal stenosis required anal dilatation
, while 2.55% is reported in literature.
They used a controversial diagnostic practice called RAD - reflex anal dilatation
- which they said indicated abuse.
In many countries, (rigid) sigmoidoscopy would have been carried out in an operating room prior to surgical haemorrhoidectomy, fistulectomy, anal dilatation
For example, despite the 44% complete response rate of fistulas in patients with perianal disease, two patients with perianal fistulas required abscess drainage, and two others underwent repeated anal dilatation
for anal stenosis.