COMPARING OUTCOMES OF SCLEROTHERAPY VERSUS RUBBER BAND LIGATION IN SECOND-DEGREE HEMORRHOIDAL DISEASE

Abstract

Background: Second-degree hemorrhoidal disease is a common anorectal condition frequently managed with minimally invasive outpatient procedures.

Objective: To compare the clinical outcomes of sclerotherapy versus rubber band ligation in patients with second-degree hemorrhoidal disease.

Methods: This randomized controlled trial was conducted at the General Surgery Department of Fatima Jinnah Medical University / Government Teaching Hospital, Shahdara, Lahore, from April 2025 to October 2025. A total of 150 patients aged 18–60 years were enrolled and randomly allocated into two equal groups. Group A underwent rubber band ligation, while Group B received injection sclerotherapy using 5% phenol in almond oil.

Results: Baseline demographic characteristics were comparable between groups. Successful treatment was achieved in 56 (74.7%) patients in the rubber band ligation group and 69 (92.0%) patients in the sclerotherapy group (p = 0.006). Recurrence was higher with ligation (25.3%) compared with sclerotherapy (8.0%). Post-procedure pain was more frequent in the ligation group (37.3% vs 16.0%), and minor bleeding occurred in 13.3% versus 6.7% of patients, respectively. Mean time to return to normal activities was shorter with sclerotherapy (1.6 ± 0.8 days) compared with ligation (3.2 ± 1.1 days). Patient satisfaction was also higher in the sclerotherapy group (85.3% vs 68.0%).

Conclusion: Sclerotherapy demonstrated superior efficacy, lower recurrence, fewer complications, and faster recovery compared with rubber band ligation.