THD vs Other Treatments: When to Choose What
THD vs Rubber Band Ligation:
Feature Banding THD
Best for Grade I-II Grade II-III
Setting Office Operating room
Anesthesia None Spinal/general
Sessions Often 2-3 One
Recovery 1-2 days 5-10 days
Success (Grade II) Similar Similar
Success (Grade III) Lower Higher
Cost Lower Higher
When to choose banding: Grade I-II, want simplest option, willing to do multiple sessions
When to choose THD: Grade III, banding failed, want single-session definitive treatment
THD vs Laser Hemorrhoidoplasty:
Feature Laser THD
Mechanism Shrinks tissue with Ligates arteries + energy repositions
Recovery 3-7 days 5-10 days
Success (Grade Good Better III)
Recurrence Moderate Lower
Cost Similar Similar
When to choose laser: Prefer slightly faster recovery, Grade II-III internal only
When to choose THD: Want best long-term results for Grade III, willing to accept slightly longer recovery
THD vs Hemorrhoidectomy:
Feature THD Hemorrhoidectomy
- Invasiveness Moderate High
- Tissue removed No Yes
- Recovery 2-3 weeks 4-6 weeks
- Pain Moderate Severe week 1
- Treats external No Yes
- Recurrence 10-15% 5-10%
When to choose THD: Grade II-III, want to avoid full surgery, minimal external component
When to choose hemorrhoidectomy: Grade IV, large external component, want most definitive treatment
Cost of THD in Abu Dhabi
Approximate Costs:
THD procedure: AED 18,000 – 30,000
Included:
- Surgeon fee
- Anesthesiologist
- Operating room facility
- Specialized THD equipment (Doppler proctoscope)
- Post-operative follow-up visits
Not included:
- Pre-operative tests (blood work, ECG if needed)
- Medications (usually AED 200-500)
Insurance Coverage:
Most UAE insurance plans:
- Cover THD for Grade III hemorrhoids (medically necessary)
- May require pre-authorization
- Coverage for Grade II varies (some insurers want banding tried first)
Check with your insurer BEFORE booking procedure.
Payment Options:
Most facilities offer:
- Direct billing to insurance (if covered)
- Payment plans (if self-pay)
- Credit card payment
Patient Assessment Information — Abu Dhabi
Same-day and next-day appointments available
WhatsApp / Phone: +971 55 318 8469
📍 Locations: Burjeel Day Surgery Centre, Deerfields · Burjeel Day Surgery Centre, Reem Island
🏥 Surgery: Burjeel Medical City (BMC)
What Makes a Good THD Surgeon?
Look for:
1. Colorectal Surgery Training:
- Fellowship-trained colorectal surgeon (not just general surgeon)
- Specific training in THD technique
2. Experience:
- Has performed THD regularly (not just once or twice)
- Can discuss success rates and complications honestly
3. Uses Doppler Technology:
- THD requires specialized equipment
- Doppler-guided ligation is more accurate than blind ligation
4. Performs Multiple Procedures:
- Doesn’t only offer THD
- Can recommend banding, laser, or surgery when those are better options
- This indicates they’re choosing treatment based on YOUR anatomy, not their equipment
5. Realistic About Outcomes:
- Explains when THD works well (Grade II-III)
- Explains when other options are better (Grade I or Grade IV)
- Discusses potential for recurrence honestly
Preparing for THD Procedure
Pre-Operative:
1-2 Weeks Before:
- Pre-operative consultation
- Medical clearance (blood tests, ECG if needed)
- Insurance authorization if applicable
Day Before:
- Light diet
- No bowel preparation usually required (unlike colonoscopy)
- Fasting from midnight
Day Of:
- Arrive 1-2 hours before procedure
- Change into gown
- IV line placed
- Meet anesthesiologist
Post-Operative Instructions:
Medications:
- Pain medication (oral)
- Stool softener (ESSENTIAL — start day of procedure)
- Possibly antibiotics (depending on surgeon preference)
Activities:
- Rest day of procedure
- Short walks starting day 1
- Sitz baths 3-4 times daily
- No heavy lifting 2-3 weeks
Diet:
- High fiber starting immediately
- Adequate hydration (2.5-3 liters daily)
Follow-up:
- Usually 1-2 weeks post-procedure
- Surgeon checks healing, addresses concerns
Frequently Asked Questions
1. Is THD painful?
Less painful than hemorrhoidectomy but not painless. Expect moderate discomfort for first week, managed with oral pain medication. Most patients rate recovery as “uncomfortable but manageable.”
2. Will I need to stay in hospital overnight?
Usually no — THD is typically day-case procedure. Occasionally overnight stay if patient prefers or lives far from hospital.
3. Can THD treat external hemorrhoids?
No. THD addresses internal hemorrhoids. If you have large external hemorrhoids or skin tags, they won’t be treated by THD. May need separate excision or hemorrhoidectomy instead.
4. How long do THD results last?
Studies show good long-term results with 10-15% recurrence over 3-5 years. Maintaining good bowel habits (fiber, hydration, no straining) reduces recurrence risk.
5. What if THD doesn’t work?
If symptoms persist or recur, options include: repeat THD (less common), hemorrhoidectomy (more definitive). Most patients have good outcomes with first THD.
6. Can I have THD if I’ve had previous hemorrhoid treatment?
Usually yes. Previous banding doesn’t preclude THD. Previous hemorrhoidectomy makes THD more complex but possible in some cases.
7. How soon can I return to work?
Desk job: 5-10 days. Physical labor: 10-14 days. Heavy manual work:
14-21 days.
8. Will hemorrhoids come back after THD?
Some patients experience recurrence (10-15% over several years). Lower recurrence than banding, higher than hemorrhoidectomy. Maintaining good bowel habits is key.
9. Is THD available in Abu Dhabi?
Yes. Available at major hospitals and specialized colorectal surgery practices. Requires specialized equipment and training, so not all facilities offer it.
10. Should I choose THD or hemorrhoidectomy?
Depends on your grade and external component. Grade II-III with minimal external → THD is excellent option. Grade IV or large external → hemorrhoidectomy usually better. Discuss with surgeon.
References and Medical Sources
THD outcomes based on clinical evidence:
1. Large THD Outcomes Study – Long-term results. Ratto C, Giordano P, Donisi L, et al. Transanal haemorrhoidal dearterialisation (THD) for haemorrhoidal disease: a single-centre study on 1000 consecutive cases. Colorectal Dis. 2017;19(8):750-756. PubMed
2. THD vs Hemorrhoidectomy Comparison – Randomized trial. Denoya PI, Fakhoury M, Chang K, et al. Dearterialization with mucopexy versus haemorrhoidectomy for grade III or IV haemorrhoids: short-term results of a double-blind randomized controlled trial. Colorectal Dis. 2013;15(10):1281-8. PubMed
3. American Society of Colon and Rectal Surgeons Guidelines – Treatment recommendations including THD. Davis BR, Lee-Kong SA, Migaly J, Feingold DL, Steele SR. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Hemorrhoids. Dis Colon Rectum. 2018;61(3):284-292. PubMed
Medical Review: Written and reviewed by Prof. Dr. Antonio Privitera, consultant colorectal surgeon, fellowship training at the Mayo Clinic and Royal College of Surgeons (UK), and European Board Certification in Colorectal Surgery.
THD Assessment in Abu Dhabi
I perform THD along with banding, laser, and hemorrhoidectomy — so I recommend based on your anatomy, not my equipment.
📱 WhatsApp/Phone: +971 55 318 8469
Abu Dhabi Locations
Multiple locations with THD capability
Proper examination determines if THD is right for you.
Professor Dr. Antonio Privitera
Fellowship-trained at Mayo Clinic (USA) and the Royal College of Surgeons (UK). Member of the Royal College of Surgeons of Edinburgh. Certified in General Surgery by the Italian Medical Council.
About the Author
