¿are the most anal diseases with incidence?
Anal diseases are basically more incidence of anal fissure, hemorrhoids and anal fistula. If it is true that there are many more in this field but the three diagnostic groups are patients with anal fissure pain, the patient with blood or a derivative prolapsed hemorrhoids or patients with an infection, anal fistula type either an abscess or a communication between the anus and the outside of your perineum.
¿, In recent years that progress has been made in the treatment of such pathologies?
In these three pathologies there have been different attempts to improve this treatment. The anal fissure, for example, have come ointments with nitroglycerin, which were tested from 2005 or so, and at first seemed an important role in the treatment of anal fissure advance but later we were seeing these patients we had to operate the same as if they had not taken nitroglycerin. In fact in 2010 a multicenter European level work showed that nitroglycerin relieves much patients but does not cure a decisive way. After a year the number of patients we had to operate was very similar to that of patients who had not taken nitroglycerin.
In the field of anal fistula there have been advances in the treatment of the most complex fistulas, less complex fistulas keep trying the traditional way, with the remaining fistulotomy wound and then the patient is healing slowly. But with complex fistulas, to try to sever increasingly sphincters with this surgery, we have devised different systems, such as glue which is like a kind of glue that gets through these fistulas, including laser fistulous orifices the advancement flap to advance hole mucosa gourd internal opening of these fistulas. But all these methods, apart from the classical fistulotomy not have a success rate equal. If it's true that many times we have no other solution to use this type of surgery or procedure to try to tackle this problem of fistula without severing much of the sphincter mechanism.
In the field of hemorrhoids progress has been made in the field using the doppler which is a system for the vascular flow of these three groups of veins that have in the anus, hemorrhoids are, and then practice a ligature or suture this vascular pedicle. Despite this we have to keep saying that classical hemorrhoidectomy is the most effective treatment and for a more definite hemorrhoids its maximum stage, stage 4. If it is true that at earlier stages continue using bands, consisting of ligation of internal hemorrhoids to stop keeping the two major symptoms are bleeding and prolapse, meaning that the patient feels that something comes out through her anus. And basically these are the advances have not been major advances in these three pathologies.