How to solve internal hemorrhoids that are prolapsed and incarcerated?
In clinical practice, for cases where internal hemorrhoids prolapse and become incarcerated, surgical treatment is often recommended. This is because the prolapse of internal hemorrhoids indicates a significant displacement and that the hemorrhoids have been prolapsed for a long time, which can lead to incarceration. In such cases, there is a risk of localized swelling or thrombosis formation, causing anal swelling and pain, and in severe cases, necrosis of the prolapsed tissue.
Therefore, it is advised to opt for surgical treatment as soon as possible for incarcerated internal hemorrhoidal prolapse. Surgical options include hemorrhoidal banding, PPH (Procedure for Prolapse and Hemorrhoids), and TST (Transanal hemorrhoidal dearterialization) among others. Anesthetic choices can range from local infiltration anesthesia, spinal anesthesia, to general intravenous anesthesia. With spinal and general anesthesia, the patient does not experience pain during surgery and does not feel fear of pain. Post-surgery, it is also necessary to select appropriate medications for dressing changes, such as anal washes, hemorrhoidal suppositories, and golden yellow ointment to promote wound healing.
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