My Experience with THD - Transanal Hemorrhoidal Dearterialization

I had THD procedure done 10 days ago, 12/19/16, and still bleeding a lot, extreme pain trying to pass a stool and haven't wandered far from couch. I am 53, slim and in otherwise perfect health. Still trying to figure out if my Surgeon was a butcher or if I am just really bad at healing from this.

I cant really offer a personal experience for the THD. That is originally the procedure that I had enquired about. In fact it the one I went to Sydney to have done (HAL-RAR). After my initial consultation Dr. Gold suggested the TST33 over the HAL-RAR due to the size and amount of degradation to the bowel wall. (Bear in mind I had "let mine go" for years due to the barbarism of the old techniques). When I went back (a year later) to finalise the cleaning up, it was again the TST33 rather than the HAL RAR due to the pain, and healing time difference. I suppose to say that after 2 weeks, I am not aware now of any discomfort or pain. For about the first week, ti felt like I had been gently kicked in the bum. Or like I had sat myself on a stone- like a dull ache. Absolutely no discomfort during a BM, and maybe a "smear or so" of strawberry jam color on the TP after wiping. Remember, Yes it is invasive, Yes it is major surgery. Also it is an area with monstrous blood flow and a lot of nerves. Plus it is a bit of your body that has to be used. You cant just put your 'poo-ing' on hold for a month while it heals. I really suggest that you explore all options when you need this type of work done. Go and see more than one surgeon, ask what they recommend and why, and then its up to you to compare the surgeon and the preferred treatment. You have to feel comfortable with your choice. Ultimately despite who your doctor suggests as a surgeon, it is still your choice. I chose the most logistically difficult possible surgeon (9 hours by plane return and a week in total in hotels) as I felt that he was the best person to trust in the above choices. Now the question is would I make the same choice again with the benefit of hindsight? Absolutely! I would change nothing. Like the car ad says in Perth, "Chose your surgeon before you chose your procedure". :-) Again I offer that if you have any questions that you may have, you can PM me or reply- I am watching this thread, and will reply. It is a pretty scary thing to have to look forward to and I may be able to answer some questions you have. Cheers Leigh

Hello, yes exactly as Leigh says, I went in thinking this was the procedure for me, but I also saw Dr Gold and was too advanced for it, I would have required way to many stitches with that procedure as I was too advanced. Also I had complications in surgery which were able to be addressed then and there as he had the experience and knowledge to do so. I am not sure were you are, but Dr Gold is in Sydney, Australia (I flew half way across the country like Leigh and would do it again). The first 10 days is still pretty fresh from surgery though so don't be too disheartened, in saying that I didn't have much bleeding at all after surgery, I had so much before surgery after a bowel movement I was expecting a flood, but nothing much at all. Make sure you are really vigilant with your stool softeners and diet it will help immensely, you don't want to push, I do hope you recover and wish you well, I had a really good experience with Dr gold and is team, like Leigh I did a lot of research before I choose my surgeon, there is a big difference between a general surgeon and specialist colorectal surgeon. Whilst recovery was not pain free, but more a dull ache, I was able to to perform all my daily tasks without a problem after about two weeks. It does take about 6-8 weeks for full recovery though. Good surgeons are pretty concerned about their work and their patients so I wouldn't hesitate to go back and see your surgeon just to double check. Wish you a speedy recovery.

Hi GM
Your story resonates with me so much I actually thought you were writing about me. I have had hemorrhoids also for about 15yrs also and the thought of the painful surgery, got me so scared that I didn't want to go through with it. After consulting with my doctor, he recommended the THD procedure
I had mine yesterday and I was up and about on less than 24 hours. No pain at all. Was amazing could not believe it. I am however experiencing the discomfort due to pressure and the urge to defecate. How did you solve this. Appreciate your reply

Hi GM. ok, well done on making the move. You will be kicking yourself you left it so long!!
The reason you have the urge to have a BM is that your butt internals are all swollen and upset. This gives the sensation of having a full bowel. I found it took some time to work out 3 things, if it was just the feeling, if it was wind, or if it was solid! I also found that I had the "urge " to clench my butt together. Almost in a "Im holding it in" way. You may also find "cranberry juice" stained paper after wiping. All of that will settle. The swelling will go down, the urge to go will subside, but you are really needing to re-learn the sensations and signals from your butt. Give it 7 ~~10 days and believe me, you want know yourself. Just remember, if you think you need to go, then go...but don't sit there and wait action- if its a false alarm, then get up and try again the next time you get the urge. Im still amazed at how good I feel after a few weeks!! Also, please remember to give it time- no heavy lifting. no squatting, no hours on the loo... Although there is no pain, you have still had a major procedure. Cheers!

Hi GM. ok, well done on making the move. You will be kicking yourself you left it so long!!
The reason you have the urge to have a BM is that your butt internals are all swollen and upset. This gives the sensation of having a full bowel. I found it took some time to work out 3 things, if it was just the feeling, if it was wind, or if it was solid! I also found that I had the "urge " to clench my butt together. Almost in a "Im holding it in" way. You may also find "cranberry juice" stained paper after wiping. All of that will settle. The swelling will go down, the urge to go will subside, but you are really needing to re-learn the sensations and signals from your butt. Give it 7 ~~10 days and believe me, you want know yourself. Just remember, if you think you need to go, then go...but don't sit there and wait action- if its a false alarm, then get up and try again the next time you get the urge. Im still amazed at how good I feel after a few weeks!! Also, please remember to give it time- no heavy lifting. no squatting, no hours on the loo... Although there is no pain, you have still had a major procedure. Cheers!

Thanks GM for your reply really put some of my concerns into perspective. Although it is really uncomfortable. I also noticed that if you do warm bath sitzs it helps with the discomfort

BE CAREFUL! This has been the most painful procedure in my life and it's been a failed procedure. I sit here now with completely closed hemeroids , gas building up to an unbelievable painful experience, 4 MONTHS after the surgery. I have an appointment with the surgeon this week, I only hope he can do something more traditional to give me some relief now. I cannot work, my business is suffering and all I read is how great this procedure is .Oh yeah? I called THD and they would not even speak with me, they sounded like they knew the drill.

Hey Tudo, I am sorry that you are not getting the relief you should be. Was it the HAL RAR technique used on you? IT seems that the method of treatment needs to be suited to the degree of the issue. I went across Australia mind set on a HAL RAR. After the consultation, my surgeon decided that the HAL RAR was not his preferred treatment. HE discussed the TST33. I had a very bad case of prolapsed hemmies. Too far gone for the HAL RAR. It is important that the treatment be the most suited to the condition. Hence I repeat, it is very important to select your surgeon carefully. I spent months researching after seeing the HAP RAR on "Embarrassing bodies" [UK]. Yes there are Doctors in Western Australia that do the procedure, I chose to cross the country to the (who I thought) was the best in the field. No regrets at all. Dr. Gold is a butt Master!!!! If you are still in pain, after 4 months, I would get a second opinion. This procedure is not barbaric at all. I was up and around in days. Never needed a Panadol for pain relief. Felt better from the moment my eyes opened. However, every butt is different and every case is different. Just saying- But I would def, get a second opinion. You don't need to be in pain.

I read the post from the guy who gave his personal experience of the THD procedure for hemorroids. Any update from him on his long term recovery?

Hi guest, just for accuracy, THD is term that actually covers several varying types of procedure. If you are using this forum to gather knowledge with a view of getting a procedure, you should try to be a little more definitive with the one you err considering. In my case I was convinced that the HAL RAR was what I needed--and probably 8 out of 10 practitioners would have done that procedure on me. It was during the consultation when the surgeon saw what I had been "cultivating" that he changed to the TST technique. The reasons were: The HAL RAR would have been more painful, a much longer recovery period, and not suitable for the degree of prolapse and the volume of Hemmies I had. Please recall that I flew to Sydney from Perth specifically for the procedure, and specifically to have the surgeon that I had. Yes, there are surgeons here in Perth that do the HAL RAR, and that is probably what I would have had. Dr Gold is a well regarded specialist who has many techniques and is able to select the most appropriate for an individual. To Answer your question about how things are after some time. Well from the time I woke up after the procedure until now (nearly 2 months) zero pain killers , not a 'panadol'. Going to the loo is a pleasure, and (now this is going to sound a bit awkward, but if you have bad hemmies, you will understand) every time I clean the shower floor I think of Dr Gold and how 'easy it is to squat down'. I have said it before, and I will say it again as it is the most valuable advice I can give. Go to a surgeon who is the best in the field. Get opinion as to what they recommend and ask the questions...why? Will it be better? will it last? what is the general recovery? and get a second opinion!!! In may case, if I ever required further work, yes, I would go back to Dr. Gold, even with a $3,000 flag fall for airfare, and hotels and out of pockets. No question in my mind.

Hi Guest, I also flew to Sydney to see Dr Gold, he is one of the best in the field. Further to "Leigh" who has described everything perfectly as I had experienced, it is most important that your surgeon is a specialist, that is not a general but a "colorectal surgeon", colorectal surgeons specialize in this area only and have had many years extra training, this is were you can run into problems if you have a more advanced case as I did and the wrong technique is used, I also had a large hematoma which was only discovered in surgery which needed to be removed, so these are the sorts of complications that can arise which are not apparent until you are under and this is why a colorectal surgeon is the way to go. This distinction might be the difference between a good outcome and not so good. I am now in perfect health, I did not realize how I was slowly deteriorating prior to surgery (10 years of suffering), although it was, as Leigh described, a costly exercise to fly over to see Gold, I waited and saved to do so, worth it and would do it again if this issue arises again, I would advise at the least to go see a "Colorectal" Surgeon for a second opinion before doing anything. Wish you all the best.

Hi,
I am from Mauritius and is kindly requesting you to give me the contact details of Dr Booyse (email address).
Kindly also inform me of the costs for this procedure in South Africa.
Thanks
Ted

Hi Ted

Dr. Booyse charged me R4,500 for the procedure, plus the anaesthesiologist at R1,600 and an overnight stay in Wilgeheuwel Clinic at R3,800.

The total for the procedure, including doctor, hospital, anaesthesiologist and theatre costs came to just under R12,000. Or US$885.00. In Mauritian Rupees, the cost is equal to MUR31,500.00.

Good luck!

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Thanks for your kind reply. Since private email are not allowed, kindly give me the address of Dr Booyse. Best regards. Ted