My Experience with THD - Transanal Hemorrhoidal Dearterialization

Hi Guest, what I did was contact the company that distribute the equipment in Australia to find out who did it. They said that there was a Doctor in each state that carries it out- so my next question was "who is the best?", I found that the person that I selected had carried out a lot of the training, had written papers, and was versed in many of the methods available. Australia is roughly the same size as the USA, and I flew from the West to the East to get that surgeon. I agree, it is hard when you cant get public opinion easily about a Doctors work, nor can the "advertise". I would suggest that you red up on him (google is your friend here). Check with his staff if he carries out several variations. That is key. The THD is but one variation of the procedure. I had it in my head that I was getting a HAL-RAR procedure, but ended up with a TST being done due to the severity. Now a HAL-RAR would have done the job, but with huge discomfort and a much longer heal/convalesce period. However, great job in looking into this side of it. It is not all in the procedure, it is the capacity of the person carrying it out.

Is it possible that a skin tag could now be causing my discomfort down there? It seems hard to locate the soreness whether inside or outside of the anus. I do know there is a tag that formed and still it's hard to locate the source of my discomfort. Roids and mucosal prolapse are still being retained thank goodness.
I live in Texas and can't be traveling for hours to see the doc who performed the surgery so I am relying on my local colorectal doc to keep an eye on me.
Fingers crossed.

I'm 51 and have had piles since I was about 11 years old. I have an attack roughly once a year when I have 2 or 3 prolapse and I am in agony for several days with spasms and then it subsides. Overall it lasts about a week. I have recently been to see a consultant in Oxford UK who has suggested banding or HALO procedure but has also suggested that natural therapies can work. I would be very grateful if anyone could advise me whether, given that 51 weeks of the year I'm ok (although I do have to be very careful going to the loo, watching what I eat) whether it would be worth me having this kind of treatment??

I had this procedure done today. I woke up in quite a bit of pain and was given two different drugs - one for pain and one that numbs the area for 72 hours. I felt pretty decent, other than wobbly; unfortunately when I got home I was SO unbearably nauseous for hours and hours that I sort of wanted to die and wake up next week. I tried to eat and just couldn't choke anything down except a few crackers and a smoothie and a few bites of soup. I took a Percocet, which was a bad idea. That just made me feel even sicker and hours later I finally threw up what felt like gallons of vomit. Fortunately the pain is minimal; I'm praying it doesn't get bad because I can't take any more pain meds.

There is a lot of bleeding and so far no bowel movement activity, which is good because I'm terrified of what that will be like. But the pain is tolerable (keeping in mind that I've taken painkillers).

I am so encouraged to hear all of your positive comments and yes, everyone is different. I have a genetic mutation (MTHFR) which causes me to be unable to eliminate toxins and drugs easily so that may be why I'm so sick. But just in case, I would advise asking your doctor for anti nausea medication if you are someone who can take it. I forgot to ask and they didn't send me home with any, but I also have mitral valve regurgitation so apparently I shouldn't take it anyway.

I'm too scared to look at mine! Lots of bleeding but the worst part is that I'm violently ill from the anesthesia and pain meds. Hope you're now feeling great!

You probably figured this out already but unfortunately while my surgeon is in network, the surgical center was not, so I did have to pay $4500 out of pocket and am hoping that's all. I just had to get this done and work out an installment plan because hemorrhoids were ruining my quality of life.
I'm glad I did it, but it's day one and I'm severely sick--I keep throwing up profusely and I can't get the nausea under control. I'm sure I'll look back and be relieved because I already had a hemorrhoidectomy ten years ago and it worked for a while but they came back with a vengeance years later.
I hope everything worked out for you!

Hello all.  I'm new here and just reading through all the content on this thread.  I'm in my mid 50s, athletic (5'9" low 160s lbs), and have suffered from hemorrhoids for about the past 5 or 6 years (Dx Apr 2013 with probably a year of issues before that).  They're now at the grade 3 stage.  They are not physically painful at all which is why I've lived with them for so long

Given the three major issues I have -

• It's difficult to clean up after using the bathroom (a bidet, when available helps tons...I installed one at home) - Toilet paper just can't seem to get me cleaned no matter how much I use and it always leads to some bleeding.
• Random bleeding, as in enough to soak through underwear and pants - always at the wrong time such as walking around a city while on vacation or in the middle of a backpacking trip (just what I want - blood on my clothes for all the bears to smell).=, or if I decide to wear white pants (whoops - I'll never make that mistake again).
• It's getting harder to reduce the hemorrhoids (push them back in) after defecating and I'm afraid they'll become grade 4 if I do nothing and my choices for procedures will be reduced.

I've decided to have the surgery and have set Aug 8 2017 as the date.   I wish it were closer as thoughts & fears keep me awake at nights, but it's not changeable.  It will be done at a major teaching university (Robert Wood Johnson in NJ) by a highly rated surgeon who has done a number of these previously, although her opinion is it won't be as pain-free as advertised.

So here's my questions for you all:

• What prep should I do (laxatives, water, fiber, etc..) and how long before the surgery date should I start?  My doctor says I don't need to take anything other than 2 enemas the night before and one the morning of, but I'd like to start off on a good footing. Did any of you change your diet pre-surgery to eat lighter / have less in your system?
• What should I have in the house for post-surgery?  Should I stock enemas, stool softener, laxatives?  Should I pick up a sitz bath?  Anything else?
• What was your post surgical diet like?  Were you eating normal immediately after?  For me, I'm concerned that my activity level will go to zero for a month and I'll gain a ton of weight (I normally get a lot of aerobic exercise)....or that I won't be able to eat at all and I'll lose weight (which I don't want to do - I'm at a healthy BMI).
• How long until you resumed work?  I've been told to expect 2 weeks (I work a desk job, often from home).  Sick time plus short term disability cover me for 27 weeks, so I won't be in a hurry if I don't feel up to it.
• How long until you stopped any narcotic pain killers?
• How long until you stopped NSAIDS?
• How long until you were able to resume all activities...I've been told to expect about a month of recovery until I can run again...and then it'll take me 2 weeks to regain the conditioning I lost from the 4 weeks off.  Hopefully I won't need longer than a month!
• For those who had this surgery a while ago - How long until you felt 100% normal?  Did you have any further issues with hemherroids? 

Thanks for any info - looking forward to putting my hemherroids behind me (gotta keep a sense of humor!)!!

Hi Gatnus, good info- but which procedure specifically are you having? There are several variants discussed on here. Some have different "after and pre care" than others. I have had the TST type, but there is also the HAL-RAR and the (very similar) THD.

I'm having THD.

Yeh, ok- I have no experience with that. I had the TST33 done. ZERO pain management. The pretreatment was pretty light on. All I did was small meals the day before, then fast from 6pm. I was 'done' at 3 pm the following day. I was given a mini enema in the hospital and that was it. Your surgeon should give you a specific protocol- perhaps call the rooms and ask what he requires. After I was done, as I have said before, I required no pain medication and took it really easy for a few days. No discomfort on any BM- and returned to work after 4 days (light duty) so no lifting or exertion. You won't regret having it fixed. I lived with the same issues as you for years, and the relief of being normal is wonderful.

I'm 10 days out and still really struggling. Feels like I have to poop all the time. I'm getting really down and it doesn't seem to be getting better as quick as I thought it would. Any suggestions?

10 days is near the turning point, or it was in my case. 14 days out, and I felt MUCH better. All I can really recommend as near-constant zitz baths. That's really what got me through it. Get a book and park off in the bath - top up with hot water as needed, and relax as much as you can. Chin up - it gets better suddenly, and once it does, you won't look back.

PS. The feeling of fullness or needing to go, may be due to some minor internal bleeding. This typically happens when the stitches dissolve, which should be around the 10 day mark. Trust me, it will get better!

Thank you. You have no idea how much I needed to hear from someone that has gone through this

Actually I have question for those that have had THD carried out- I went to my surgeon expecting to have the HAL-RAR procedure done. He suggested that I have the TST instead. When I asked him why his response was, it is more competent procedure for my condition (my Hems were pretty sizeable + a degree of prolapse) plus as it is all carried out above the dentate live the pain is minimised and the post procedure pain management is also far better. I went with his suggestion (he is the expert anyway). Now as soon as my procedure was done, and I came out of the anaesthetic- there was no pain. In fact I almost felt relief... when he did his rounds I asked how long the local that he used would last. There was no local...that was it. He suggested that I may need some paracetamol for a day of so, but I need nothing. There was no pain- maybe some discomfort sitting, but in reality it was no worse than sitting on a butt full of hemies! Hence my query, have those that have had THD discussed alternatives with their surgeons? It would seem to me that the THD is laced with a longish recovery and vast discomfort- where I experienced zero, narda, nothing!! In fact one year after the first TST I required a second as my condition was so bad to start with. I had issues for 8 years and refused to do anything about it after hearing stories of traditional hem-ectomies. Both my procedures were as I have described. I had it done at 2pm Friday and discharged from hospital at 8pm same day. Then flew back to Perth from Sydney (5 hours) on Sunday and back to work on the Monday. No pain during BM and healed brilliantly. I suggest you speak to your surgeon and look into alternatives to the THD or the HAL-RAR. 

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I had my THD procedure 2 weeks ago . It was a nightmare! I had a really bad bleeding and hospitalized for a week and end up having blood transfusion. But before all of this happened, the only thing my doctor told me was how safe it is .......after all , I think all the procedures have risks and complications! THD is not as safe as everyone thinks !