Botulinum Toxin A Before Hemorrhoidectomy to Prevent Postoperative Pain
Recruiting
Phase 2Interventional Study
HemorrhoidsPostoperative Pain
Prior Safety Data
This treatment has already been tested in at least one earlier human trial.
Ready to participate?
Review the details below, then apply to join this clinical trial.
At a Glance
Age
18 and older
Sex
Any
Trial phase
Phase 2
Study type
Interventional
Purpose
Prevention
Participants needed
292 (estimated)
Sponsor
Lomonosov Moscow State University Medical Research and Educational Center · Other
Who this trial is looking for
This trial is looking for adults with severe hemorrhoids who are scheduled for surgery. Participants will receive an injection before surgery to see if it helps reduce pain afterward.
Are You a Good Fit for This Trial?
You may be able to join if
I am at least 18 years old.
I have been diagnosed with grade III or IV hemorrhoids.
I have not had success with other treatments.
I am scheduled for hemorrhoid surgery.
You may not be able to join if
I am allergic to botulinum toxin A or local anesthetics.
I have a neuromuscular disorder.
I have taken certain medications in the last 14 days.
I have a bleeding disorder or cannot stop blood thinners.
I have an active anorectal infection or inflammatory bowel disease.
I have previously had anal sphincter surgery.
I am pregnant or breastfeeding.
I have significant health issues affecting anesthesia.
Summarized in plain language from this trial's official eligibility criteria.
The full criteria are further down this page — only the research team can
confirm whether you qualify.
Think this trial could be right for you?
Answer a few quick questions to see if you may meet the eligibility requirements.
Hemorrhoidectomy is an effective surgical treatment for advanced hemorrhoidal disease but is often associated with significant postoperative pain, which may delay recovery. One of the main contributors to pain after hemorrhoidectomy is spasm and increased tone of the internal anal sphincter.
This randomized, double-blind, placebo-controlled clinical trial evaluates whether preoperative injection …
Hemorrhoidectomy is an effective surgical treatment for advanced hemorrhoidal disease but is often associated with significant postoperative pain, which may delay recovery. One of the main contributors to pain after hemorrhoidectomy is spasm and increased tone of the internal anal sphincter.
This randomized, double-blind, placebo-controlled clinical trial evaluates whether preoperative injection of botulinum toxin type A into the internal anal sphincter, performed seven days before hemorrhoidectomy, can reduce postoperative pain compared with placebo. Adult patients with grade III-IV hemorrhoids scheduled for excisional hemorrhoidectomy will be randomized to receive either botulinum toxin A or saline injection prior to surgery.
Postoperative pain intensity, analgesic consumption, complications, functional outcomes, and patient satisfaction will be assessed during the first 30 days after surgery.
Trial Locations
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Eligibility Criteria
Inclusion Criteria:
* Adults ≥18 years, male and female
* Symptomatic grade III-IV hemorrhoidal disease (Goligher), refractory to conservative treatment
* Scheduled for open (Milligan-Morgan) or closed (Ferguson) hemorrhoidectomy
Exclusion Criteria:
* Known hypersensitivity to botulinum toxin A, …
Inclusion Criteria:
* Adults ≥18 years, male and female
* Symptomatic grade III-IV hemorrhoidal disease (Goligher), refractory to conservative treatment
* Scheduled for open (Milligan-Morgan) or closed (Ferguson) hemorrhoidectomy
Exclusion Criteria:
* Known hypersensitivity to botulinum toxin A, human albumin, or local anesthetics.
* Neuromuscular junction disorders (e.g., myasthenia gravis, Lambert-Eaton syndrome).
* Use of aminoglycosides or other agents interfering with neuromuscular transmission within 14 days.
* Coagulopathy or ongoing anticoagulant therapy not suitable for perioperative interruption.
* Active anorectal infection, fissure, abscess, or inflammatory bowel disease in the active phase.
* Previous anal sphincter surgery or baseline fecal incontinence.
* Pregnancy or breastfeeding.
* ASA ≥ III or significant systemic disease compromising anesthesia or wound healing.
* Participation in another interventional clinical trial within 30 days.
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