A new minimally-invasive embolisation procedure to treat haemorrhoidal disease — a very common medical condition that impacts the lives of many South Africans — was recently performed for the first time at Netcare hospitals in Johannesburg and Cape Town, and is now being offered as a standard treatment option at these facilities for appropriate cases.
Interventional radiologists Dr Gary Sudwarts and Dr Maja Wojno successfully performed the newly introduced rectal artery embolisation procedures at Netcare Park Lane Hospital and at UCT Private Academic Hospital (UCTPAH) recently. Dr Sudwarts says that the intervention has shown most promising results internationally in the treatment of haemorrhoids, or piles as they are often known, since it was first introduced overseas in recent years.
“This approach, which has a number of advantages over the surgical removal of haemorrhoids, including that it is painless and recovery times are greatly reduced, is showing itself to be an invaluable new treatment option for haemorrhoidal disease patients in South Africa,” observes Dr Sudwarts.
“Pleasing outcomes have been achieved globally with the minimally invasive embolisation procedure, which involves blocking the blood vessels that are supplying the haemorrhoids with blood, causing them to shrivel and die. The procedure is safe and has achieved a meaningful reduction in symptoms and improved quality of life for patients,” notes Dr Sudwarts.
Dr Sudwarts, who practises at Netcare Park Lane Hospital in Johannesburg and UCT Private Academic Hospital in Cape Town, is now offering the procedure as a standard treatment option to appropriate patients.
He explains that haemorrhoids are blood vessels situated in the muscles of the walls of the rectum and anus. The blood vessels may become debilitating and a medical problem when they are persistently swollen, causing pain, bleeding and/or severe itching in the anus. It is estimated that half of the population will experience piles at some point in their lives.
While most cases of haemorrhoidal disease are not serious and symptoms often go away on their own, or can be easily managed through an improved diet and lifestyle and the use of prescribed and over-the-counter medicine, they may in some cases swell significantly and cause incapacitating symptoms. Such cases may require surgical intervention particularly in patients in whom bleeding is the main symptom.
“Specialists will commonly first treat haemorrhoid disease using a rubber band over the enlarged haemorrhoidal vein. Eventually, however, some patients require surgical removal of haemorrhoids, which is called a haemorrhoidectomy.
“Haemorrhoidectomy has traditionally been a standard treatment approach for more serious cases of this condition, although ultrasound guided interventions and other approaches are also available today. As the anus is a highly sensitive area, the haemorrhoidectomy can be extremely painful and recovery can take two weeks or more. In addition, in some cases the haemorrhoids can re-occur.
“On the other hand, the embolisation procedure is a safe day procedure used in cases of severe and persistent haemorrhoid disease causing uncomfortable and debilitating symptoms, and may also be considered for patients for whom surgery is not an option due to other co-morbidities. Patients are discharged home the day of the procedure, and tend to recover much quicker and report little or no post-operative pain,” notes Dr Sudwarts.
The managing director of the Netcare Hospital division, Jacques du Plessis, congratulated Dr Sudwarts — who has in recent years actively worked to introduce new non-invasive embolisation treatment procedures to South Africans whose lives have been negatively impacted by conditions such as uterine fibroids in women and enlarged prostate glands in men — for introducing the procedure.
“Dr Sudwarts’ practice is the first on the African continent to be offering the new procedure, which brings hope to the many patients whose quality of life has been severely impacted by haemorrhoid disease,” he says.
Haemorrhoid disease is often linked with persistent constipation or diarrhoea, obesity, poor posture, too much sitting down, previous surgery on the rectum, cancer and sometimes pregnancy. External piles hang down outside of the anus and may need to be pushed back in after a stool has been passed, and can be prone to secondary skin infections.
According to Dr Sudwarts, persistently swollen haemorrhoids can cause severe discomfort and pain and in some cases they may be a symptom of a more serious underlying medical condition. He recommends that anyone who has rectal bleeding or blood in their stools should seek medical attention. A medical practitioner will investigate what is causing the rectal bleeding or if there is an underlying condition that is causing the haemorrhoids to enlarge.
“While there remains a need for studies to assess the long-term effectiveness of the haemorrhoidal embolisation technique, the fact that it is safe, painless and is showing good short-term results, is making it an increasingly popular option internationally. We are excited to be offering the new minimally invasive option in South Africa,” concludes Dr Sudwarts.
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