Anal duplex fails to show changes in vascular anatomy after the haemorrhoidal artery ligation procedure

Aim  The aim of this prospective study was to evaluate whether the beneficial effect of haemorrhoidal artery ligation/transanal haemorrhoidal dearterialization (HAL/THD) is attributable to a change in the vascular anatomy at the level of the corpus cavernosum recti. Method  Patients treated by HAL/THD for Grade II or Grade III haemorrhoids were scanned by anal colour Doppler endosonography before treatment and 6 weeks postoperatively. As part of a randomized controlled trial, patients were treated either with or without the Doppler scan. The number and diameter of vascular structures were measured at the distal, mid and proximal levels in the anal canal. Results  There were 30 patients in the non-Doppler group and 34 in the Doppler group. The postoperative measurements of the anal colour Doppler endosonography did not show any significant differences in vascular anatomy compared with the preoperative measurements, regardless of whether the Doppler probe was used (P > 0.05). Conclusion  This study failed to show that the effect of HAL/THD is caused by alteration of the macroscopic vascular anatomy in the corpus cavernosum recti.