Abstract
Background
Warm water sitz bath is advised for a variety of anorectal disorders. However, preparation of the sitz bath is sometimes difficult for patients. As an alternative to the sitz bath, we have adapted a water spray method. A randomized, controlled study was conducted to determine if the water spray method has similar effects to the sitz bath in the post-hemorrhoidectomy period and it is easy to carry out.
Methods
A total of 120 patients were randomly assigned to water spray or sitz bath groups. All patients received analgesics and a fiber-rich diet after hemorrhoidectomy. Clinical parameters including pain, irritation (burning or itching sensations), hygiene, convenience, and overall satisfaction were evaluated by a visual analog scale to assess treatment outcome in both groups.
Results
There was no obvious difference in age, gender distribution, body mass index, or duration of disease between groups. There were no significant difference in scores for postoperative pain (p = 0.23), irritation (p = 0.48), or hygiene (p = 0.725) between groups. However, the water spray group reported significantly greater convenience (p < 0.05) and higher overall satisfaction (p < 0.05) compared with the sitz bath group. At the end of the 4-week postoperative follow-up period, 90% of patients in the watery spray group and 93% of patients in the sitz bath group showed complete wound healing. There were no significant differences in postoperative complications between groups.
Conclusion
Our results demonstrate that the water spray method could provide a safe and reliable alternative to the sitz bath for post-hemorrhoidectomy care. Furthermore, the water spray method could be used instead of the sitz bath as a more convenient and satisfactory form of treatment.
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References
Bleday R, Pena JP, Rothenberger DA, Goldberg SM, Buls JG. Symptomatic hemorrhoids: Current incidence and complications of operative therapy. Dis Colon Rectum 1992;35:477–481. doi:10.1007/BF02049406.
Shafik A. ‘Somatoanal’ reflex or ‘thermosphincteric’ reflex? Dis Colon Rectum 2000;43:726–728. doi:10.1007/BF02235602.
Ferguson JA, Mazier WP, Ganchrow MI, Friend WG. The closed technique of hemorrhoidectomy. Surgery 1971;70:480–484.
Whitehead W. The surgical treatment of hemorrhoids. BMJ 1882;1:148–150.
Milligan ET, Morgan CN, Jones LE. Surgical anatomy of the anal canal and the operative treatment of hemorrhoids. Lancet 1937;2:1119–1124. doi:10.1016/S0140-6736(00)88465-2.
Ho YH, Seow-Choen F, Tan M, Leong AF. Randomized controlled trial of open and closed haemorrhoidectomy. Br J Surg 1997;84:1729–1730. doi:10.1002/bjs.1800841223.
Gencosmanoglu R, Sad O, Koc D, Inceoglu R. Hemorrhoidectomy: Open or closed technique? A prospective, randomized clinical trial. Dis Colon Rectum 2002;45:70–75. doi:10.1007/s10350-004-6116-1.
Hetzer FH, Demartines N, Handschin AE, Clavien PA. Stapled vs excision hemorrhoidectomy: long-term results of a prospective randomized trial. Arch Surg 2002;137:337–340. doi:10.1001/archsurg.137.3.337.
Janicke DM, Pundt MR. Anorectal disorders. Emerg Med Clin North Am 1996;14:757–788. doi:10.1016/S0733-8627(05)70278-9.
Ramler D, Roberts J. A comparison of cold and warm sitz baths for relief of postpartum perineal pain. J Obstet Gynecol Neonatal Nurs 1986;15:471–474. doi:10.1111/j.1552-6909.1986.tb01426.x.
Friend WD. Hot sitz baths. Med J Aust 1995;162:448.
McConnell EA. Giving your patient a sitz bath. Nursing 1993;23:14.
Wang LT, Wu CC, Hsiao CW, Feng CC, Jao SW. A modified Ferguson hemorrhoidectomy for circumferential prolapsed hemorrhoids with skin tags. Dis Colon Rectum 2008;51:456–461. doi:10.1007/s10350-007-9179-y.
Johanson JF, Sonnenberg A. The prevalence of hemorrhoids and chronic constipation. An epidemiologic study. Gastroenterology 1990;98:380–386.
Thomson WH. The nature of haemorrhoids. Br J Surg 1975;62:542–552. doi:10.1002/bjs.1800620710.
Tejirian T, Abbas MA. Sitz bath: where is the evidence? Scientific basis of a common practice. Dis Colon Rectum. 2005;48:2336–2340. doi:10.1007/s10350-005-0085-x.
Shafik A. Role of warm-water bath in anorectal conditions. The “thermosphincteric reflex.”. J Clin Gastroenterol 1993;16:304–308. doi:10.1097/00004836-199306000-00007.
Shafik A. Role of warm water bath in inducing micturition in postoperative urinary retention after anorectal operations. Urol Int 1993;50:213–217.
Gupta PJ. Effects of warm water sitz bath on symptoms in post-anal sphincterotomy in chronic anal fissure—A randomized and controlled study. World J Surg 2007;31:1480–1484.
Okeke LI. Fournier’s gangrene in Ibadan. Afr J Med Med Sci 2000;29:323–324.
Lara-Torre E, Hertweck SP, Kives SL, Perlman S. Premenarchal recurrent periclitoral abscess: A case report. J Reprod Med 2004;9:983–985.
Goto S, Mori M, Fukaya Y, Nakamura K. Nursing measures against adverse reaction from anti-cancer chemotherapy. Nippon Rinsho 2003;61:943–948.
Hatagawa K, Tatsuzono K, Matsumura S, Sato Y. Instructions on daily activities of hemorrhoid patients with special reference to sitz bath. Kango Gijutsu 1975;21:60–68.
Dodi G, Bogoni F, Infantino A, Pianon P. Hot or cold in anal pain? A study of the changes of internal anal sphincter pressure profiles. Dis Colon Rectum 1986;29:248–251.
Kahraman A, Karaca K, Etoz A, Ozcan M. Perianal burn as a complication of hemorrhoid treatment caused by hot water sitz bath. Burns 2004;30:868–870.
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Hsu, KF., Chia, JS., Jao, SW. et al. Comparison of Clinical Effects Between Warm Water Spray and Sitz Bath in Post-hemorrhoidectomy Period. J Gastrointest Surg 13, 1274–1278 (2009). https://doi.org/10.1007/s11605-009-0876-9
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DOI: https://doi.org/10.1007/s11605-009-0876-9