THD: A New Approach to Hemorrhoid Treatment

Medically reviewed by: Gary H. Hoffman, MD

Many hemorrhoids can be managed with methods like topical treatments, but if hemorrhoids keep growing back often need surgical intervention. Typically, this amounts to an excisional hemorrhoidectomy, or the more recently-developed procedure for prolapse and hemorrhoids (PPH). Though both of these methods are effective, they have a potential for being uncomfortable, and so the search for a pain-free cure for hemorrhoids continued.

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Here is a video of Dr. Hoffman speaking about THD (Transanal Hemorrhoidal Dearterialization) Treatment:

Now, a new procedure has entered the playing field: transanal hemorrhoidal dearterialization (THD) is a minimally invasive procedure that offers another way to resolve hemorrhoids in Beverly Hills.

What is THD?

Hemorrhoids start out as normal vascular structures that aid in stool control. It is only when these structures become swollen and inflamed due to increased arterial flow or other venous issues that they become problematic.

THD - A New Approach to Hemorrhoid Treatment

Rather than removing tissue as in a hemorrhoidectomy, THD addresses the problem by locating the terminating branches of the hemorrhoidal arteries with a Doppler device. Then, the artery is tied off with a suture, while outflow continues through the veins to reduce the swelling. If a prolapse has occurred, a hemorrhoidopexy is performed to place that prolapsed tissue back into its proper place, also without excising tissue.

THD often causes only minimal discomfort and typically takes just over 30 minutes to complete. It is performed in an outpatient setting and many do not even need to take pain medication after the procedure.

Does THD Work?

So far, the answer appears to be that it does accomplish its goals. In one study, THD cured 85 percent of patients and made a marked improvement in the condition for another 7 percent. Some studies have directly compared THD to PPH and found the two to be equally as effective, but some pain scores were better after THD. Bleeding and prolapse both exhibited high rates of control, while the rate of recurrence was a mere 4 percent.

THD is not the be-all end-all treatment for hemorrhoids, but this new technique is certainly a valuable tool in the fight against this painful problem.

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