My Experience with THD - Transanal Hemorrhoidal Dearterialization

I'm 42, pretty much the same story. I have the THD scheduled.
How are you still holding up?
Any reoccurrence any particular things that are causing you problems?
Thanks for the Post!

Hey there 42. So where are you going to have the procedure done? Have you selected a full colorectal surgeon or a lesser qualified practitioner? I had my second procedure done on December 16th, and flew back to Perth from Sydney on the Sunday (18th). I have had a pretty boring recovery. No special events, no pain no discomfort. Well, let me qualify that. When we got back, we did go shopping and I did carry some heavy bags (Dr Gold would have yelled about that one) so I did cause a little bleed. I spoke to Dr Gold, and he talked me thru getting it sorted out. But stupidity aside, I'm in the the best Butt shape I've been in for a long time. Just minimise the time you sit and wit for action on the loo. If its not going to happen, get off and wait until it is. When it does happen, do it, then get off. Its not a place to fond peace, you need to minimise the time and quantity of visits to the loo. If you have specific questions, please ask.

Hi Ted, here you go:

Address Room 27 Block A Life Wilgeheuwel Hospital,
Amplifier Road,
Radiokop Ext 13, 1724
Location Roodepoort, City of Johannesburg Metropolitan Municipality, Gauteng, South Africa

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Thanks for your help

Hi, HALO and THD are just 2 different brands of equipment. The procedures are almost identical, using ultrasound to locate the precise position of the arteries to be ligated. I am day 4 from my THD, having had 3 arterial ligations, and apart from not getting proper advice about hydration prior to the procedure, everything has gone as expected. I also had a secondary prolapse repair (I am 59, and had longstanding damage from tearing in childbirth at 28, which weakened my internal sphincter, and resulted in an anterior rectocele) I think that explains why it is taking me a while to regain a sense of normality. My advice, is take the pain meds as advised. Don't wait for pain then try to get on top of it. Eat loads of fruit and veg. Drink loads of water and take regular stool softeners. I'm sitting in a warm bath twice a day. On my first night it was 1.30am, soothing and best way to gently clean the area. I was a little optimistic thinking I would be back at work after just a week. I have a sedentary job, so not the best idea. I find I have an almost constant dull ache, which is eased by the regular paracetamol and ibuprofen. BMs are frequent and small, and painful. The warm baths are good after any particularly challenging sessions. I bought a Squattie Pottie last week, hoping a better squatting position would help avoid straining. I've ended up, squirming, getting up and pacing and generally finding BMs difficult, but it is exactly what my surgeon said would happen, so I just need patience. Hope this helps. I have found others comments on the whole, reassuring.

Had THD done April 2016 after banding failed to stop bleeding. Extreme complications. Sitz baths to maybe urinate. 3 days later ER for foley catheter that had to remain for several weeks. 23 days no bowel movement. Extreme pain could barely walk. Return to work after 10 weeks still cannot perform job like able to preop. pain after every BM to this day. Second opinion suggest sutures too high and pull and stretch after BM. Recommend full hemorrhoidectomy. 3 month recovery. Still reeling financially from lost time from last years procedure. Alternative is to "get used to it, don't think about it" LOL, and no, will not prescribe any Pain meds.
OTCs don't touch the pain.
Retirement is near and it may have to wait till then as it takes a long time to make up for 3+ months of no work.
My suggestion is to do the research, find the absolute best colorectal surgeon in your area.

Hello, I had the THD done 15 days ago to the 3 internal hemorids . Dr ties off the main blood vain supplying the hemorids then puts 2-3 stitches in them to pull them back up in place. When I came back into recovery room I WAS IN so much pain, in which Dr said he had never had this happen. They had to almost knock me out with pain meds to just ease the pain. Dr had to take me back tinto surgery and cut the stitches that was used to pull the hemorids back up in place. He said one of the stitches was in a nerve running in/around the hemorid so not knowing Which one he had put a stitch though he had to cut all of the stitches that was pulling my hemorids back up into place..? After waking up from the 2nd surgery the pain was much better. But believe me not great!! Sent home, no BM for 3 days even with only fluids and a high fiber diet. I had no choice but to strain some to get a small amount out, size of a small cat t**d...plenty of blood with it worst pain ever! Even taking two 7.5 narcos an a Valium for the throbbing anal pain. Day 4 felt like another BM was knocking on my rump, light strain two bloody size cat turds and 2 larger one about the size of a small dog t**d. The releaf was like night and day. Pain almost gone! I was so damn happy I could walk normal even out in the yard that day... But it was short lived to just that day. Soaking in hot baths is your best friend, it srenks the hemorids to make the pain manageable for a while. I always take stool softeners twice a day with mirilax. I eat my normal meals, vegs, ham and a few burgers and only still get marble size runny BM. Called Dr. He told me to take 4 dulcolax and a bottle of Magnesium Citrate.. after all that at one time, only a small cat t**d... I was calling Dr damn near every other day!!! I took 4 tablespoons of Milk of Magnesia that night, the next morning I had a BM, no pushing or straining and had to flush twice! OMG what a relief it was for the pain in my anus!! I can now have small BM several times a day, not much but it helps! It's been 2 weeks now and I've only had 3 days where I could walk around comfortably with the pain being around a 2-3 most days it's a 7 -15 yes that bad. I've got to believe my issues are due to Dr having to cut the stitches that are used to normally pull the hemorids back up and hold them in place until they dry up. I go back to Dr on Friday and not looking forward to it! At this point I would he rather just remove ALL of them. Sick and Tired!

I'm afraid I cant make the point loud enough. There are many procedures that are along the same practice. That is ultrasound arterial location, and then a stitch to stop the blood flow. That is what I originally wanted to have done. I had a serious issue having put up with it for about 14 years, then delaying a procedure for around 8 years or so from when it should have been done! I then saw the HAL-RAR on UK embarrassing bodies. I researched the procedure, and pretty much everything about it. Then came surgeon selection. I found the best in Australia to do it. It entailed a flight to the other side of the country, a hotel for a week for 2 (the wife and I). It was a tough decision to make, but the fact is, once there, the HAL RAR was not his ideal choice for me. My condition was so bad that the opportunity for that style was well passed. HUGE hemmies, and lots of stretched tissue and prolapse. I ended up having a TST procedure. All decided while I was on the table. Your choice of surgeon is paramount to a good recovery. I did not require any medication for pain. Nothing- Zip - Zero - Narda!!!! Now that may not always be the case, but the point I make is this: "if someone is going to do something that is that loaded with potential issues and pain, give yourself the best shot". Choose a surgeon who has the largest selection of procedures at their fingertips and is the most competent you can find. I see there people in pain and wonder why would you do it to yourself. If your GP refers you, make sure you ask if the person is a fully fledged colorectal surgeon. Then research and do your own study. You cant put your butt off duty while you heal for a few weeks.

Hi folks,
I am not a patient, but a doctor anaesthetist. Our surgeons started doing THD recently. For this procedure and any other type of surgery for haemorrhoids or other anal procedures patient could have general anesthesia or regional anesthesia - caudal or spinal-subarachnoid anaesthetics. If general anesthesia is the choice, then additional local anaesthesia by means of bilateral pudendal block and perianal infiltration with local anaeathetic drugs helps a lot thru the surgery and particularly for postop pain management. Although you might hear from a surgeon THD is painless, because there is no skin cuts, that is not the case in most of the patients. So if you want a smoother postop period ask your anaesthesiologist to do pudendals and perianal infiltration. These are useful even for procedures done under regional techniques, because they have prolonged effect. Additional pain relief you can get by taking 6 hourly oral tylenol together with tablets tramadol or tapentadol. There are ready-made combination of paracetamol-tramadol in tablets called zaldiar or ultraset, which you can use 6-8 hourly as well.

Hi again, I quite agree with the detailed above post with repeat to pain management. The THD is certainly one that can require some pain relief and can have an extended healing period. When I attended my surgeon, one of the points made for not doing the HAL-RAR was that a lot of the procedure may be carried out low in the bowl (towards the end). This area does indeed contain a lot of nerves and pain is an issue. The procedure that was suggested to me, and I went with was a TST. With this the work (cutting and repairing) is carried out higher than (or above) the pectinate line. Below this the anal canal is very sensitive and rich with nerves. It is these nerves that assist in evacuating the bowl. Now with my procedures, there was zero pain and zero discomfort. No medication required at all. This is why I keep banging on about ensuring that the procedure you select is the right one for you. If you select a surgeon that carries out only 1 type, then you are going to be somewhat limited in the selection you can have. I traveled by plane for 4 hours 15 to get to Sydney and 5 hours to get back, plus arranged hotels for several days in Sydney. Extreme??? Not at all- would do it again exactly the same. I had the right man for the job. I went for a HAL-RAR, spent months researching it, then in a 20 minute consult walked out with a TST procedure booked for that afternoon after hearing the benefits and drawbacks of both. You MUST ensure that you have the right man for the job.

Hi all, I am now 4 1/2 weeks post op and for the most part am doing ok but yet I continue to have a burning sensation and splintery feeling in my anus. Had all six areas ligated and full mucopexy by a very qualified surgeon. I am wondering how long this discomfort
will last and what I can do about it. Could it be suture related? Thanks.

I found that I felt 100% by 4 weeks, but my doctor cautioned me about being too active too early. Apparently, the operation still requires a full six weeks to heal properly. As such, you may well still experience some very mild discomfort at this point. Rest assured, however, that now - 6 months after my procedure - I can't believe I waited so long to have it done!

Can I suggest that when a post is put up regarding a procedure that some geographical reference be put in the post- For example I am located in Western Australia- had my procedure carried out in Sydney. This way we can build a reference of surgeons and their respective post procedure convalescence regime. We may see a commonality or some fa factors that may be relative to the execution of the procedure. Any thoughts?

Thanks for that info G. Hopefully my situation will turn out like yours. I am probably a bit too active which isn't good. I am hoping my discomfort may be suture related.
Yes LW, I agree with you. I had my surgery in Orlando and had to travel really far to obtain the surgeon and facility that I think is top notch.
I had a traditional hemmy surgery years back and wouldn't recommend it to my worst enemy. So far theTHD far outweighs the old methods.Just hope the long term results are favorable with this.

Can I ask people - how you selected your surgeons? I'm scheduled for surgery in Aug. My surgeon has been listed as a "top doctor in NJ" and works at one of if not the biggest medical center in the state...I know she's done the surgery for at least a few years - but I have no way of contacting previous patients / finding out what results are.