Radiofrequency coagulation versus rubber band ligation in early hemorrhoids: pain versus gain

OBJECTIVE: Band ligation of internal hemorrhoids is a well-established and accepted office procedure. However, there are several reports focusing on problems associated with this technique, which is perceived by many to be risk-free. This randomized study is aimed to compare radiofrequency coagulation and rubber band ligation of hemorrhoids on the parameters of effectiveness and comfort.

MATERIAL AND METHODS: Eighty patients of 2nd degree bleeding piles were randomized prospectively for band ligation (44 patients) or radiofrequency coagulation (36 patients) technique. Parameters measured included postoperative discomfort and pain, time taken to return to work, complications accompanying the procedure and recurrence rate.

RESULTS: The post defecation pain was more severe with band ligation (p=0.01) and so was rectal tenesmus (p=0.01). The patients from radiofrequency coagulation group resumed their duties early (2 versus 5 days, p=0.05). Recurrence rate was higher in radiofrequency coagulation group.

CONCLUSION: Rubber band ligation is associated with significantly higher post treatment pain and discomfort. As against this, radiofrequency coagulation results in significantly less pain and post defecation discomfort. However, chances of recurrence of bleeding and prolapse of hemorrhoids are comparatively higher using radiofrequency coagulation of hemorrhoids.