Dr. Wolff (Laser Medizin Zentrum Rhein-Ruhr) about haemorrhoidal diseases and their therapy

After working for many years in various clinics and specialized rectal centers in Germany and Switzerland, Dr. med. Katja Wolff started her work at the Laser Medizin Zentrum Rhein-Ruhr in Essen at the beginning of 2019. Dr. Wolff is a specialist in surgery and coloproctology and specializes in laser therapy.

1. Dr. Wolff, what diseases do you deal with in proctology?

The word proctology comes from the Greek "proktos" = anus.
In proctology we deal with all diseases and complaints of the rectum and anal canal. Often a physician with this additional designation also works as a coloproctologist and therefore also deals with the diseases of the intestine (colon).
Typical common diseases are haemorrhoidal diseases, inflammations of the anal skin (anal eczema), tears in the anal mucosa (anal fissures), prolapse of the anal mucosa (anal prolapse), enlarged skin flaps in the anus (mariscs), pus foci and pus ducts in the anus (anal abscess and anal fistula) and inflammations of the coccyx (coccyx fistula).

2. They say a common disease is haemorrhoidal disease. What exactly are haemorrhoids and what symptoms can occur?

Hemorrhoids are vascular pads located in the mucous membrane of the rectum. Hemorrhoids per se are something natural and very important for the fine closure of the anus.
However, when patients talk about "haemorrhoids", they usually mean complaints that can be caused, for example, by enlarged haemorrhoidal cushions.
Frequent complaints are itching, burning in the anus and a wound feeling in the anus. In addition, patients often notice blood on the toilet paper and a foreign body sensation on the anus.

3. For many people, diseases of the rectum are still a taboo subject. Why is an early visit to the doctor important?

Complaints in the anus are something very unpleasant and, due to the fact that blood, for example, is seen, quickly trigger a feeling of anxiety in those affected.
Unfortunately, the anal region and the diseases in this area are still taboo. Patients are afraid to undergo a medical examination at an early stage because they are afraid of a painful examination and are also embarrassed by the symptoms.
An early visit to a proctologist, however, is very important so that a diagnosis can be made and a correct therapy can be started. In most cases it is a question of benign diseases, such as haemorrhoidal disease. Malignant diseases of the anus are rare overall, but should be detected early so that they can be treated well.
Many diseases are treated primarily conservatively and an operation is not immediately necessary.

4. They also work with LHP^® laser therapy. What are the advantages of laser therapy?

In the anal region, many anatomical structures such as the rectum and the sphincter are located in a very narrow space. The aim of a proctological operation should therefore always be - as far as it is possible from a medical point of view - to spare the neighbouring structures.
LHP^® laser therapy for haemorrhoids is less invasive and therefore well tolerated by the patient. With this method, the enlarged haemorrhoidal knots are reduced and not completely removed. This reduces the risk of weakness of the sphincter muscle. Patients have little pain after the operation and can quickly return to their daily routine.
An additional advantage is that the operation can be performed on an outpatient basis.

5. What experience have you had with laser therapy? (also with regard to relapses)

The patients who we have treated at the Laser Medizin Zentrum Rhein-Ruhr to date are satisfied and have no recurrences.

6. Do you also treat other proctological diseases with laser therapy?

Laser proctology can be used to treat enlarged haemorrhoids, coccyx fistulas and anal fistulas very well.
Coccyx fistulas can also be treated very well on an outpatient basis with the SiLaC^® method, and the earlier large wounds, which take a very long time to heal completely, can be avoided.
The therapy of anal fistulas, the so-called FiLaC^® method, is a surgical method that is gentle on the sphincter muscles. Whether the patient is suitable for this method is decided by a detailed proctological examination.

Further information can be found at: https://www.lmz.de/english-1/