Nonsurgical treatment of thrombosed external hemorrhoids using non-ablative Er:YAG and Nd:YAG laser

Background In recent years, non-ablative lasers, such as neodymium and erbium lasers generated by yttrium aluminum garnet (Nd:YAG and Er:YAG), have been used for treating various female pelvic floor disorders. Objective To evaluate the effectiveness of nonsurgical treatment of thrombosed external hemorrhoids using a non-ablative erbium and neodymium laser. Methods This was a retrospective study that analyzed data from charts of fourteen female patients with thrombosed external hemorrhoids associated with severe pain syndrome, which underwent a single procedure of perianal area irradiation with a non-ablative erbium and neodymium laser in PIANO mode. Results The assessment of pain using a visual analog scale directly after the 15-minute procedure decreased from 8 (7;10) to 1 (0;2) points (р<0.0001). The severity of defecation pain was reduced over a week from 8 (7;10) to 0 (0;2) points (p < 0.0001). One week after treatment, pain syndrome was completely absent, and half of the women having none remaining of hemorrhoids. No complications or symptom deterioration were observed. No patients were with recurrence of hemorrhoids for six months follow up. Conclusion A single procedure of combined exposure to a non-ablative erbium and neodymium laser on the perianal area in patients with thrombosed external hemorrhoids seems to effectively alleviates pain syndrome and promotes rapid symptoms regression. Larger-scale, long-term, and well-controlled studies are needed to confirm the results of this small pilot study.