Dilation of the sphincter

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The maximum anal stretching of the sphincter , also called maximum stretching according to Lord , is a method that is no longer used for the treatment of symptomatic hemorrhoids (hemorrhoids).

description

The sphincter ( Greek: sphincter ) is stretched under anesthesia . The doctor in charge will stretch the sphincter to the maximum with four fingers in both hands . This method is based on the hypothesis that primary hypertension of the muscles of the internal sphincter ani (internal anal sphincter ) is the cause of the hemorrhoid disease. The maximum elongation according to Lord can lead to an irreversible destruction of the sphincter apparatus through an uncontrolled rupture. The incontinence rate of the procedure is up to 52%. In the guidelines of the German Society for Coloproctology from 2008, the use of this procedure is therefore rejected.

The Lord's maximum elongation was developed in 1968 by the British doctor Peter H. Lord.

further reading

  • R. Ruppert, B. Kirchdorfer: Surgical therapy of hemorrhoidal disease. In: Visceral Surgery. Volume 41, No. 6, 2006, pp. 388-393. doi : 10.1055 / s-2006-955193
  • BH Lenhard: Hemorrhoids - differential diagnosis and therapy. In: The dermatologist . Volume 55, No. 3, 2004, pp. 240-247. doi : 10.1007 / s00105-004-0688-5
  • JU Bock, J. Jongen: Diagnosis and therapy of haemorrhoid disease. In: Visceral Surgery. Volume 37, No. 1, 2002, pp. 48-53. doi : 10.1055 / s-2002-20331
  • R. Winkler: Hemorrhoids. To evaluate the various surgical procedures. In: The surgeon . Volume 72, Number 6, June 2001, pp. 660-666, ISSN  0009-4722 . PMID 11469086 . (Review).
  • PH Lord: Digital dilatation for hemorrhoids treatment. In: International surgery. Volume 74, Number 3, 1989 Jul-Sep, pp 144-145, ISSN  0020-8868 . PMID 2606613 .

Individual evidence

  1. ↑ a b P. H. Lord: A new regime for the treatment of haemorrhoids. In: Proceedings of the Royal Society of Medicine. Volume 61, Number 9, September 1968, pp. 935-936, ISSN  0035-9157 . PMID 5679021 . PMC 1902648 (free full text).
  2. ↑ J. Konsten, CG Baeten: Hemorrhoidectomy vs. Lord's method: 17-year follow-up of a prospective, randomized trial. In: Diseases of the Colon and Rectum . Volume 43, Number 4, April 2000, pp. 503-506, ISSN  0012-3706 . PMID 10789746 .
  3. ↑ A. Herold, C. Breitkopf et al: Haemorrhoidalleiden. ( Memento of the original from April 25, 2012 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. (PDF; 749 kB) Guidelines of the German Society for Coloproctology, AWMF , as of July 2008 @1@ 2Template: Webachiv / IABot / www.awmf.org