Plication of haemorrhoids [haemorrhoidorrhaphy]

Introduction: haemorrhoidal disease [HD] involves prolapse of vascular cushions limited to the anal canal and perianal area. Symptomatic HD is dealt with by non-operative and operative methods, which aim at reducing the Haemorrhoidal cushions and their covering mucosa. Surgical treatment offers the best chance of permanent cure. The ideal procedure for treatment of HD should be simple, minimally invasive, correct all the anatomical abnormalities and avoid early recurrence of symptoms. HD, however disabling, is harmless. Treatment should therefore never induce a significant element of risk to the patient

Aim of the work: is to suggest and try a simple but air effective method of surgical treatment for HD that suits all symptomatizing degrees of the disease

Patients and methods: The suggested method depends on the use of interrupted stitches that tailor the lining of the anal canal almost back to normal without incisions or excisions

Results: the results of this plication or haemorrhoidorrhaphy are obliteration of vascular ectasia, occludsion of feeding cessels, refashioning the redundant mucosa and providing support for the disintegrated fibromuscular submucosal tissue that precipitates the HD

Conclusion: this method minimizes, almost to nil, per- or postoperative bleeding, and leaves no rate areas however advanced is the disease

Carcinoembryonic antigen determination in urine differentiates early bilharizal from nonbilharzial urinary bladder carcinoma

Both urinary Bilhariziasis and urothelial neoplasia are associated with increased production of tissue carcinoembryonic antigen [CEA]. Urine and serum CEA were determined in 43 patients with urinary bladder carcinoma including 22 post bilharzial and 21 nonbiharzial cases, in addition to 10 normal control cases. A significant increase was detected in both urine and serum CEA levels with bladder carcinoma compared to control cases. Urinary CEA was significant elevated in 86% of bilharzial, versus 62% in nonhilharzial bladder carcinoma. Only 10.5% of control cases had urinary CEA elevation. The mean urinary CEA in bilharzial cases, was higher than that of nonbilharzial carcinoma, but the difference was not statistically significant. There was a definite relationship between urine CEA and the stage of malignancy; the higher the stage, the higher the level of urine CEA. No relationship could be detected between the stage of malignancy and serum CEA, or between the grade of malignancy and urine or serum CEA levels. In conclusion, urinamy CEA is more useful than serum CEA in the early detection of urothelial carcinoma particularly if provoked by bilharziasis. Its level is also correlated with the tumor stage