 Radio frequency removed of hypertrophied anal papillae and fibrous anal polyps

Abstract

Objective: The presence of hypertrophied anal papillaeand fibrous anal polyps is mostly ignored while dealingwith chronic anal fissures. However, anal papilla tendsto produce a discharge resulting in a sodden perianalskin with itching and discomfort. Similarly, polyps canprolapse, bleed or traumatize. This study is aimed toassay the impact and utility of attending to these twoconditions concurrently while dealing with cases offissure in ano.Method: A prospective study was carried out in 100patients of chronic anal fissure with concomitanthypertrophied anal papillae or fibrous anal polyp. Radiofrequency surgical technique was employed to destroythe papillae and polyps after a lateral sphincterotomy.Associated complaints like pruritus, prickingsensation, wetness, crawling in the anus etc. weresubjected to comparison before and after removal ofthe papillae or polyps by an independent observer.Results: At a follow up of one month, anoscopyconducted on the patients showed total eradication ofthe treated papillae. The associated symptoms werereduced significantly and there was a marked declinein the primary complaints of pain and bleeding. At 24-month follow-up, 2% patients had recurrence of fissure,but none was found to have the papilla or polyp.Conclusion: Hypertrophied anal papillae and fibrousanal polyps encountered during surgical treatment ofchronic fissure in ano should be removed to improvepatient compliance. Radiofrequency procedure cantackle these associated pathologies effectively.Key words: Hypertrophied anal papilla, fibrous anal polyp,radio frequency surgery, fissure in ano.