Efficacy and safety of sclerotherapy with polidocanol in children with internal hemorrhoids

Abstract

Background Hemorrhoids are an extremely rare condition in children, and data on its incidence and treatment in the pediatric population remains scarce. We retrospectively reviewed children who underwent sclerotherapy for internal hemorrhoids, and analyzed patients' characteristics and outcomes. Methods A total of 14 pediatric patients who underwent sclerotherapy were included. Patients' ages and the required amount of polidocanol, depending on the grade of hemorrhoids, and the correlation between age and volume of sclerosant, were statistically analyzed. Results Patients had a male predominance with a ratio of 2.5:1 (grade 2:6 patients, grade 3:8 patients). Four children had underlying conditions including portal hypertension and Klippel–Trenaunay syndrome. Of the 14 patients, 43% had constipation requiring medication or enema. Only one minor complication, a perianal ulceration, was found to be associated with sclerotherapy. Patients with grade 3 hemorrhoids required a significantly larger amount of polidocanol than those with grade 2 hemorrhoids. Two patients with grade 3 hemorrhoids required a second session of treatment for recurrence. The success rate of sclerotherapy with polidocanol was 86%. Conclusions Sclerotherapy with polidocanol is a safe, effective, and less invasive treatment option for internal hemorrhoids in children. Further studies are needed to investigate this treatment approach.

Long-term efficacy and safety of cap-assisted endoscopic sclerotherapy with long injection needle for internal hemorrhoids

“…Polidocanol is a commonly used injection sclerotherapy that has been widely used for injection sclerotherapy of internal hemorrhoids[ 14 , 15 ]. Polidocanol is injected into the anus mirror or via colorectal colonoscopy under direct intravascular injection of pathological changes and causes minimal damage to the mucous membrane tube and anal cushion.…”

Hemorrhoidal Disease: How to Proceed After Unsuccessful Medical Treatment?

“…The procedure benefits patients with mild to moderate symptoms who do not respond to conservative measures such as dietary changes and topical medications. Sclerotherapy is considered a safe and effective alternative to surgical intervention in these cases and may also be helpful for patients who are unable or unwilling to undergo surgery [39].…”

“…The procedure is typically performed on an outpatient basis and may be repeated as necessary to achieve the desired results. Studies have reported varying success rates of sclerotherapy in treating hemorrhoids, depending on the severity of the condition and other factors [39,40]. However, on average, sclerotherapy has been shown to have a success rate of approximately 70-80% in treating first-and second-degree hemorrhoids.…”

Sclerotherapy in Hemorrhoids

“…Patients with grade III hemorrhoids required a significantly larger amount of polidocanol than those with grade II. Sclerotherapy with polidocanol was a safe and effective treatment for children with symptomatic hemorrhoids, which was simple to operate with minimal anesthesia and was associated with very low morbidity [ 25 ]. HIV-positive patients should avoid rubber band ligation [ 26 ].…”