Guidance
3 The procedure
3 The procedure
3.1 Electrotherapy (also called electrocoagulation) aims to provide a treatment for patients with grade I or II haemorrhoids, as an alternative to banding, and for patients with grade III or IV haemorrhoids as an alternative to surgery.
3.2 With the patient in the left lateral position, a proctoscope is inserted into the anus to identify a haemorrhoid. A probe with metal contact points is then placed at the base of the haemorrhoid above the dentate line and a direct electric current is delivered. The electric current is controlled by a handpiece attached to the probe. The time for which the electric current is applied depends on the grade of the haemorrhoid and on the dose of direct current. The aim of the direct current application is to cause thrombosis of the feeding vessels and to cause the haemorrhoid to shrink. The precise mechanism of action is not known. More than 1 haemorrhoid may be treated at each session, depending on the need and tolerance of the patient.
3.3 One approach uses a low amplitude direct electric current (between 8 mA and 16 mA) and is used in an outpatient setting. Another approach described in the literature uses a higher amplitude direct electric current (up to 30 mA) with the patient under general or spinal anaesthesia.