REMOVAL OF LESIONS IN THE AREA OF THE ANUS AND RECTUM

What are the lesions in the area of ​​the anus and rectum?

The most common lesions in the area of ​​the anus and rectum include:

• lesions caused by the HPV virus (condyloma acuminata)
• anodermal marginal folds
• hemorrhoids
• anal fissure

How do we treat?

Before the procedure of removing the lesions, you should see a proctologist for a medical consultation. During such a visit, the doctor conducts a detailed interview and a proctological examination of the patient with an assessment of the intensity of the reported symptoms and the degree of advancement of the lesion. At this time, you should also mention all diagnosed chronic diseases and daily medications in order to assess their impact on the risk of complications. Based on the information obtained, the doctor verifies the indications for surgery and presents available methods of treatment.

lesions

Anal warts (condyloma acuminata)

• Anal warts (condyloma acuminata) are caused by human papillomavirus (HPV), the most common sexually transmitted disease. Warts affect the area around and inside the anus, but they can also develop on the skin around the genitals and in the mouth. They first appear as small spots or growths, often as small as a pinhead. They can grow quite large and cover the entire anus.
  Treatment options for genital warts include:
  
  
  • Externally applied creams and ointments for genital warts - these usually work best if the warts are very small and only on the skin around the anus,
  • Cryosurgical excision of the lesions,
  • Laser therapy
  • Surgical excision of anal warts
  • Electrocautery

Anal marginal folds

• Anal marginal folds are excessively enlarged and loose folds of skin at the edge of the anus (anoderm). Most often, these changes are unnoticeable to the patient and are accidentally detected during a proctological examination. However, in some people they can be a source of many complexes and discomfort, which results from the presence of bothersome symptoms, worsening the patient's quality of life. These are usually:
• burning and itching around the anus,
• difficulty maintaining personal hygiene,
• visible protruding skin folds on the edge of the anus,
• feeling of lack of aesthetics,
• risk of frequent inflammations around the anus.

Anodermal folds most often develop after perianal thrombosis (a complication of hemorrhoids) and as a result of childbirth. An additional factor contributing to the development of these changes is heavy and strenuous physical exertion, often associated with lifting.

Hemorrhoids (varicose veins of the anus)

Hemorrhoids, or itchy growths near the anus, are enlarged hemorrhoids, which become a source of symptoms. Hemorrhoids are a physiological structure; they are plexuses of blood vessels filled with blood. When they become excessively filled, i.e. congested, they cause symptoms and are then referred to as hemorrhoids. Depending on which vascular plexus is enlarged, we distinguish:

• internal hemorrhoids, which are initially not visible from the outside, but can be felt during an examination of the anus;
• external hemorrhoids, visible in the area of ​​the anus as soft, bluish growths. They are a fairly common condition affecting about 11% of the population, most often between the ages of 45 and 65.

• habitual constipation,
• diarrhea,
• pregnancy,
• sedentary lifestyle,
• long-distance running.

The most common symptoms accompanying hemorrhoids are:

• bleeding or an admixture of fresh blood, accompanying bowel movements and usually related to constipation,
• itching and burning in the anus,
• feeling of incomplete bowel movement,
• mucus discharge.

Internal hemorrhoids may fall out during the urge to defecate and spontaneously retract into the anal canal.

The diagnosis is made during a proctological examination, during which the doctor first examines the area around the anus and the anus itself, then performs a finger examination through the anus (per rectum). The next stage is a speculum examination - anoscope, assessing the interior of the anus. Sometimes, a rectoscopy is also performed, i.e. assessment of the entire section of the rectum using a speculum.

Untreated hemorrhoids can lead to ischemia, blood clots and the development of nodular necrosis. Treatment depends on the stage of the disease, the severity of symptoms and the age and general condition of the patient. Conservative, instrumental and surgical treatment is used.

Conservative treatment consists of regulating bowel movements and avoiding constipation through an appropriate diet and changing behavior during defecation. Local preparations in the form of suppositories, ointments or creams are also used, the purpose of which is to have an astringent, anesthetic, anti-inflammatory and protective effect.

Instrumental methods include: cryotherapy, laser therapy, electrocoagulation, application of rubber bands to hemorrhoids (rubber banding).

Laser therapy is performed at the Bellazone Clinic. A comprehensive article is available in the offer Proctology -> Laser treatment of hemorrhoids.

The third group of treatment methods are surgical methods involving surgical excision of the nodules. This is the method with the highest risk of complications.

Anal fissure

Anal fissure is a linear tear in the mucous membrane of the anus, most often located on the side of the coccyx. The disease mainly affects young people - between 20 and 40 years of age. The main symptom is a burning pain in the area of the anus, intensifying during bowel movements, as well as minor bleeding. Symptoms of a fissure can be acute - when they are severe and last for a short time, or chronic, when they last for a longer period of time.

Usually, an acute anal fissure resolves spontaneously, but if it is not treated, it can become chronic. Then there is a risk of inflammation of the anal canal, scarring, and consequently the formation of a fold on the edge of the anus.

Available treatments:

Cleaning of the anal fissure to facilitate healing

Surgical treatment is mainly undertaken in the case of a painful chronic anal fissure. The doctor cleans the overgrown tissue and scarring, and then brings the edges of the fissure closer together. Healing of the anus takes about 6 weeks. During the convalescence period, it is necessary to follow the recommendations of the proctologist regarding diet and hygiene of the anus area. The patient should report for a check-up examination of the anal canal (anoscopy).

Method of injecting the internal anal sphincter with botulinum toxin

If increased tension of the internal sphincter muscle is diagnosed, the doctor may decide to inject this muscle with botulinum toxin. The internal sphincter relaxes - this is a reversible process lasting up to several months after the procedure. This allows you to break the vicious circle of pain, facilitate healing and prevent recurrence of the fissure.

Conservative treatment

Pharmacological treatment aims to improve the physical properties of the stool - mainly to soften it. This reduces the risk of mechanical irritation of the mucous membrane. Thanks to this, we reduce the risk of recurrence of the fissure or other anal disease associated with disruption of the continuity of the mucous membrane.