High-intensity focused ultrasound rectoanal lifting (HIFU-RAL) for prolapsed hemorrhoids: a case series

Prolapsed hemorrhoids can affect quality of life, owing to associated pain and other symptoms. Although hemorrhoidectomies are curative, postoperative complications such as pain, bleeding, and delayed recovery are unavoidable. Some patients cannot undergo surgery due to comorbidities or social factors. These challenges highlight the need for minimally invasive, immediate treatments. This study explored the effectiveness of high-intensity focused ultrasound rectoanal lifting (HIFU-RAL) in 10 patients with grade IV hemorrhoids. The procedure was completed within 13.5 ± 3.2 min. Immediately afterward, the prolapsed lesions visibly shrank or disappeared. No prolapse was observed between 9 days and 3 months following HIFU-RAL, and no adverse events were reported. Heating induced by HIFU may have triggered contraction of the longitudinal muscles, repositioning the hemorrhoids to their anatomical location and visually reducing the prolapsed lesion. HIFU-RAL is a promising, minimally invasive treatment for prolapsed hemorrhoids that can be performed immediately in a consultation room.