My Experience with THD - Transanal Hemorrhoidal Dearterialization

Hi. I was up and about pretty much within 2 days after the surgery. I was a little tender but able to care for my kids on my own. I was back at work within a week but probably could have gone back to work earlier. You are unable to lift heavy things for a week after the op so lifting the kids was out but overall i felt great after having it. Not sure if your in Australia however if you are, i definitely would recommend seeing Dr gold for advice about your best possible options for you. He was very understanding of my needs re my care for my kids as well as looking at the best possible surgery for me. Best of luck to you and don't put off having the op. ..best thing i have ever done

Hi and thanks for the reply. I pretty much had a similar set of circumstances, two kids, and ten years of suffering this terrible and somewhat secretive condition, I also had chronic anemia from bleeding hem's on top of it.

I had it on good advice that Dr Gold was the best in Australia, it is important to find a specialist colorectal surgeon not just a general surgeon this is were you run into problems if your situation is not straight forward or minor. Thank goodness I had the good sense and the means to fly the other side of Australia to see Dr Gold, his practice is in Sydney. I recommend trying to pull the funds together to do so as my situation was advanced, and although I had convinced myself the Hal-rar would be ideal it turned out not so, I also had other complications arise in surgery which were addressed then and there which again is why you really need to see a colorectal surgeon as no two situations in there are the same. I ended up with the TST33 which is used for advanced cases and sometimes the degree of hem's is not always apparent until surgery which is why you need access to other procedures.

Surgery went smoothly, there was some pain on awaking but the anesthetist was great and addressed it straight away. I had sufficient pain relief, and had mostly worked myself up into such a tizz prior to surgery about the level of post operative pain, that I thought afterwards that it wasn't all that terrible after all. I will admit, I was completely petrified of opening my bowels, however you will be given all the necessary medication and laxatives and make sure you have a high fiber diet, although it took three days post op, it was sensitive and mildly uncomfortable but not at all as bad as I was anticipating, I took Dctr's advice, just don't push, keep waiting it will come, (as agitating as that feeling is).

I was up and walking around by day 2, I didn't feel any direct pain throughout recovery just tender and swollen, by day 5 the tenderness had subsided substantially.

I am so glad I had it done, I cant believe I put up with this horrendous situation out of fear of pain post-op, I cannot recommend Dr Gold enough, there is no need to go through the pain of an old fashioned traditional hemorrhoidectomy when newer and more advanced procedures are available.
Also worth noting I have tried every natural method under the sun just like every other sufferer, before I finally gave in.

I have found this board so helpful over the last few weeks, thank you to those who have posted it had helped me immensely.

THD Surgery Report:

DATE - 22 November, 2016 (17:00CAT)
LOCATION - Johannesburg, South Africa
SURGEON - Dr. Stefaan Booyse
FACILITY - Life Wilgeheuwel Hospital
AGE - 42
GENDER - Male
CONDITION - Prolapsed Rectum and external hems

After years of fighting with Stage 2 piles, I finally went to see Dr. Booyse, who came highly recommended. I was diagnosed with diverticular disease at a young age, and as such have always had to pay attention to my diet and my colon. However, the piles were driving me mad, and then my rectum started prolapsing. This is not sexy. And it is uncomfortable, debilitating and humiliating. So I went to see the doc, and he told me about the THD surgery. I went home and started doing some research. And then, despite some of the negative comments on this site, I booked the surgery as above.

It is now the third day after my procedure, and if you don't want to read the whole thing, here's the short answer: SUCCESS! Less pain than anticipated. And I can't believe I waited so long to have it done.

In more detail: My surgeon prefers to do his operations in the afternoons, and see patients in his rooms in the morning. As such I was booked to arrive at the hospital around 12:00 for admission. Prior to this, I had tried to eat soup for two days before the procedure, and took some fibre additives to help make sure everything was soft down there.

At the hospital, I was quickly admitted, and moved to a general surgical ward, since I would be staying over night (with the procedure only happening in the afternoon, my doctor wasn't keen on letting me go home on the same day, which I appreciate). I was issued with a sexy gown and the ugliest undies you've ever seen. I put these on and lay down with a book. Soon after, a nurse arrived to administer an enema. This is no fun, but wasn't painful at all. I had to lay on my side, while she stuck the lubricated tip of the enema into my anus. A firm squeeze of the enema container deposited a lot of gunk in my colon. I was told to lie as still as possible, and to try to keep it in for as long as I could. I managed about 15 minutes, after which I shuffled carefully to the toilet - a blowout at this point would be disastrous! Made it to the toilet without mishap, had a pretty impressive dump, and then struggled to retract my rectum (for the final time! hurrah!).

Returned to bed, picked up my book and waited. Unfortunately there was an elderly patient who had a perforation in her colon, and my surgeon had to perform an emergency procedure on her. So that pushed my own procedure back to 17:00 in the afternoon. At this point the nursing staff gave me some Dormicum to make me relax, and wheeled my bed to the pre-operating area.

I waited there for about 20 minutes, after which I was wheeled into the operating theatre. Once inside, I had to scramble from my warm, comfy bed onto a rather uncomfortable operating table. Made especially for this purpose, it had my ass positioned higher than my legs. Not sexy, but hey - I was wearing the terrible underpants anyway, and getting lucky was far from my mind at the time.

Next came the general anaesthesia. This was administered via a drip that was put in as soon as I arrived in theatre. The staff were friendly and professional throughout, and the doctor came to speak to me briefly again before I was put under. Last thing I remember was an oxygen mask being put on my face.

I woke up in recovery, with no pain at all. I was there for a bit (kinda woozy on the details), before they wheeled me back to the ward where my wife was waiting. I quickly regained my senses, and even though I had a slightly full feeling in my rectum, there was no pain. I spent the evening lying mainly on my back, drinking water and reading my book.

Turns out they were pumping pain meds into the drip that was still attached, which is why I felt no pain. I fell asleep and had a good night's rest. The staff woke me at 04:45 to take a sitz bath. This was heaven - by now I was feeling a bit of pain, and a lot of discomfort - fullness, mainly. Also, the doc had stuck some gauze between my butt cheeks, with a massive bandaid across both cheeks to keep it in place. Being male, this bloody thing hurt the hair on my ass, and somewhere during the night I must have pulled it off. No biggie - it was just there to stop any leakage, and I had none.

So off to the sitz bath, which is highly recommended. Mine was nice and warm, shallow and only had a disinfectant in it. I've seen recipes for epsom salts and fancy things to be added, but I believe it is really the temperature that matters most. It eased my discomfort, and I was feeling great.

Except for one thing: I couldn't urinate at all. I'd been drinking water since I got back to the ward, and I was bursting for a pee. But I just couldn't get it out. Found out later that this is very common with the THD procedure, especially with males. The doc came to see me and discharged me - but only if I managed to pass urine. Otherwise it was a catheter for me - and I didn't want that!

I tried walking around slowly, praying, pushing gently on my bladder and taking on more water. Nothing. The doc game me a Urimax capsule, but that did nothing either. I've had a bladder issue once before, and knew that Urispas might do the trick. So I got the nursing staff to ask the doc for one of those. He was hesitant, but relented in the end. And 20 minutes later it was dam busters! So I took an Uber home.

I was sent home with 20 Stilpains (the heavy dosage), as well as 4 sachets of Movicol stool softener. I've been taking the Movicol religiously, and firmly believe it is my saving grace! I've taken pain meds regularly, but only as needed - and I really haven't had all that much pain.

I had my first bowel movement (BM) on Thursday afternoon - remember, I had the procedure on Tuesday afternoon. By then I was feeling very full, but wanted to wait so I could go without straining. Initially it hurt a little - sharp, shooting pain. But then it subsided as the long, soft stool just flowed out. Wonderful!

Since then I've had three more BMs, all without pain or incident. I still watch what I eat (avoiding red meat and diary, concentrating on fruit, etc.) and I took Movicol again today. I'll probably continue with it for a couple of weeks, just to be 100% sure I don't do any damage to the fine work Dr. Booyse did.

So overall, my experience was extremely positive, with very little pain and only mild discomfort. In terms of the actual problem, it seems 100% sorted. I've not had any protrusions from my rectum, which is the most important thing. OH! I left out the bit about a soft silicone-like plug coming out of my rectum during a sitz bath the day after the procedure. No pain, but I felt something sticking out during the morning's bath, and was very worried that the surgery was failing. Then, I took another bath in the afternoon, and found a soft plug had slipped out. Again, not sexy, but hey...

Anyway, I'm now on my third day after the procedure. I drove the kids to school this morning, and am about to fetch my oldest daughter after her exam. I wouldn't say everything is back to normal by any means yet, but the pain is completely manageable, the discomfort being the only thing that still bugs me. That, and the fact that I still struggle to urinate sometimes. Other times no problem, but every now and again, it just doesn't want to work. I've found that a hot shower helps...

Anyway, my overall reaction is extremely positive. If I keep getting better like I am at the moment, I'll be back to normal a week after the procedure. I've got a follow-up visit with the surgeon scheduled for Wednesday, and will report back once I've been. But for now, all good!

If I can give any advice:
- Make sure you are in good hands - check that your doc is experienced with this procedure!!!
- Try to eat soft foods and fibre in the days leading up to your procedure
- Sitz baths are your friend
- Take the stool softeners religiously and don't be stupid about the food you eat afterwards. Stick to soft food!
- The pain is totally bearable, but don't be shy to take pain killers as needed
- It is uncomfortable, for sure, but with the right doctor, care and food, you can be back to your sexy self a week after surgery
- If you live in the UK, try to avoid letting the NHS do this - private is the way forward. I've heard too many horror stories, and been treated by the NHS myself when I lived there. It just isn't worth it if you can't be guaranteed proper care (this last point is completely opinionated and shouldn't be taken too seriously, but for a supposed first-world country, the medical treatment in the UK sucks)

That's all folks. I'm happy to answer questions if needed.

Just a quick follow-up, as promised. I saw my surgeon one week after the procedure, and he was very pleased with the outcome. He did remind me that it will take four to six weeks for everything to finish healing down there, so "please don't go mountain biking yet".

With that said, I now feel healthy enough to do just that. I have to add that things got fairly rough after my previous post. The first three days were a breeze - but then it got sore. So painful that I struggled to turn over in bed, for instance. And I woke up with an immense pain in the ass every day. But a sitz bath sorted that, and I didn't hold back with the pain meds. It was three tough days, but around Day 5 or 6, things became much, much better. A week after the procedure, and I'm pretty much back to normal. Or better :)

I dont know if you will get a notification for this as it has been a few months , but I have an THD scheduled for Dec. 8 in saint Anna hospital in Sofia. How are you feeling these months post op? Where did you get your surgery done? I will check for replies in the next few days , please if you get notified , leave a comment.

I dont know if you will get a notification for this as it has been a few months , but I have an THD scheduled for Dec. 8 in saint Anna hospital in Sofia. How are you feeling these months post op? Where did you get your surgery done? I will check for replies in the next few days , please if you get notified , leave a comment.

What was the final outcome? How are you now? I'm experiencing the same course as you and waiting for my follownup this week

I'm so glad that you have had your issues remedied and that you are feeling better. It had been 2 months since my surgery and i have never felt better. I am still eating a high fibre diet and taking my softeners (only because i am off the the usa and the plane trip, change in climate and food may impact my bowl motions so it was recommended that i stay on them until i get back) with a view of reducing my dose upon my return from os and still driking lots of water. Ithey than that i feel great and no longer stressing about going to the bathroom which i was constantly in fear of. Again i am glad to hear you are feeling better and so happy to hear that i didn't give you a bum steer (pardon the pun) re my recommendation to see dr gold. Best of luck to you.

hi, not sure you still reading this, where in the uk did you do it? i am thinking in doing it at the BMI but not sure... thanks

hi, where in the uk did you do your THD? thanks! how was it?

OK, so I am the 55 year old male from Perth (posted 22-12-2015 in this forum) I had a TST 33 performed by Dr. Gold as wellI also flew from Perth to Sydney to have it done. It was a perfect solution. literally no pain. Over the last year, I did have a small re-occurance. Now given what I had to start with a year ago, I had fully expected to have this. My original condition was extreme. I had prolapsed hemmys that would just bleed cleaning the shower, with every BM, the pain and discomfort just sitting was terrible. I have just returned from Dr Gold again after a second TST33 to clean up what was left. I can not speak highly enough of the man and the procedure. There is some really good technology out there to solve this hideous problem. A traditional surgery is fully barbaric and just not needed. The bigger thing to consider is not only the procedure you have done, but as "fluffy" so well put, who does it. Dr. Gold warranted me flying from Perth to Sydney twice. SO the out of pockets are a serious consideration, along with hotels, taxis etc. Now the big question is not am I happy with the result, or how good it was, the question now is 'with the advantage of hindsight, if I had to plan the treatment again, would I change anything?' The answer is NO. Absolutely nothing. Dr Gold is without a doubt a leading surgeon in his field and if a man is going to go, where no man has been before, I want the best.
This forum is so good for people to be able to share experiences and knowledge from a "point of view" stance. Who better to learn from than someone who has actually had it done. .. and frankly, who else but someone who can recommend highly a practitioner! Don't put up with the pain and discomfort when you can painlessly have the issue addressed. Again I offer that you can pm me if you want further info.

OK, I am a 55YO male living in Western Australia [Australia]. I have suffered with haemorrhoids for around 6 years and the last year was hell. Found the HAL-RAR procedure on "Embarrassing Bodies (UK)". This led me to research the technique. I heard that the best in Australia was in Sydney and contacted Dr. Darren Gold. I arranged from Perth to travel there to have it done. After inspection during the initial consult he suggested a different technique as my 'roids' were so large and prolapsed. He explained the TST-33 to me, and it was decided under his guidance that this would be the best for me. Less pain, much shorter healing time and higher success rate for advanced roids. That same evening the procedure was carried out. Took around 90 minutes, and after 2 hours I was in my room. From that point, the lack of pain was strange. No pain medication required AT ALL. The following morning at around 8am I was seen by Dr. Gold during his rounds. Asked if there was any bleeding or pain, I said no. I was asked if I wanted to be discharged. I left the hospital at 9am and went back to the hotel. Remember I am from West Aust, and this is in Sydney. I experienced no pain, no bleeding as such, just a little pinkish discolouration. I can not believe that anyone would put up with the daily anguish of roids when this procedure is available. It may not be for you as no 2 bums are the same, and certainly no conditions are the same, but I would confidently recommend Dr. Gold as your first point of contact or at least for a second opinion. I found that very often success is not so much the procedure done, but the performer of that procedure. Choosing the best procedure for your specific issues is also a critical part of the treatment. You need a surgeon who can select from as a wide a suite of treatments as possible. and be able to perform them competently. For me it involved a week across Australia and it was the best decision I have made. I was sold on the HAL -RAR, but it would have given me a much longer recovery period and pain. I am happy with the result and being a chicken when it comes to pretty much anything medical would do this again in a heart beat. For specifics about my procedure, you are welcome to PM me

Hi Leigh, couldn't agree more with everything you mentioned, the surgeon and their experience is the most important factor, given all the horrendous stories on here, I made sure I had done extensive researched before I had this surgery, I am only 5 weeks post op and doing great, I hope it all holds together! But so far so good and I too would not hesitate to go back and have it done again, I hope you are fully recovered after surgery 2, it is a shocking thing to put up with, I suffered just like you described and it was seriously impacting my life, thanks for your reply, your initial post was really helpful to me, as I too wanted information from those who had had the surgery, all the best for your recovery!

I am so glad to hear you are travelling without the daily anguish of this condition, I took my children overseas earlier this year prior to surgery and it impacted my holiday enormously, I really knew I needed to do something after that experience (took me three hours every morning to pull myself together - literally), it gives me great hope after ready about yours and "Leighs" experience. I too am feeling so good, I had forgotten what normal was, no bum steer here at all! It has been the best thing I have every done actually, Best of luck to you too!

I suffered for more than 8 years with shocking hemmys. My sister had hers repaired the old way (hemorrhoidectomy) she recalls crying before going to the loo and says it was like passing barbed wire and broken glass- she shows her fingers and thinks there is still porcelain under there nails from hanging on to the loo 20 years ago. I saw the HAP RAR on the UK show embarrassing bodies, and then started researching. Contacted the company and watched every video I could on it. It was such relief when I even considered a procedure that was "pain free" (ish). Then it was a matter of finding the practitioner. That in itself was a little tricky- remember Australia is as vast a land as the USA, so going to the other side for a procedure was a very serious commitment.
Dr Golds team worked with me to minimise the duration of the trip (and therefore hotels etc). He is so confident and competent in his rooms. While I was there he said that the HAL RAR was not the best for what stage that I was at. Hence the TST-33. The very fact that he took the time and was so user friendly, when it came time to make the choice, I simply said that I was putting my butt in his hands and treat it like was his own. His "after sales service" (follow up) is terrific. As I said, I cant fault the guy. I am fairly homophobic, and its far it, butts and hemmys are not an ideal subject to discuss or "handle", but I felt total dignity the entire time. Look, there are heaps of doctors that do the procedure in Australia, and I am sure that they have varying levels of skills and qualifications. Looking at the experience that Dr Gold has and the papers that he has published reinforced my decision. I simply wanted the best for my butt, and that is what my research told me.
Maybe Im a bit anal about research (yes, pun fully intended), but I'm very much a measure twice, cut once sort of guy.