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. 2013 Aug 14;19(30):4944-9.
doi: 10.3748/wjg.v19.i30.4944.

Treatment of hemorrhagic radiation-induced proctopathy with a 4% formalin application under perianal anesthetic infiltration

Narimantas Evaldas Samalavicius  1 , Audrius Dulskas, Alfredas Kilius, Kestutis Petrulis, Darius Norkus, Arvydas Burneckis, Konstantinas Povilas Valuckas
Affiliations

Treatment of hemorrhagic radiation-induced proctopathy with a 4% formalin application under perianal anesthetic infiltration

Narimantas Evaldas Samalavicius et al. World J Gastroenterol. .

Abstract

Aim: To evaluate the results of hemorrhagic radiation proctopathy treatment with a 4% formalin application.

Methods: A prospective study was performed. Over a three-year period, 38 patients underwent 4% formalin application under perianal anesthetic infiltration for hemorrhagic radiation proctopathy. All patients included in the study were irradiated for prostate cancer. The patients ranged in age from 56-77 years (average 70 ± 5 years). All of the patients were referred for formalin therapy after noninvasive management had failed. Twenty-four (63.2%) patients underwent a single application, 10 (26.3%) patients underwent 2 applications, and 4 (10.5%) patients underwent 3 applications.

Results: Two to 36 mo (average 12 ± 3 mo) following treatment, 34 patients were interviewed (four were lost to follow-up). Twenty (58.8%) subjects reported complete cure, 8 (23.5%) subjects reported significant improvement, and 6 (17.7%) subjects reported no change. One patient (who underwent a colostomy at a regional hospital with no specialized services available for previous bleeding episodes from radiation proctopathy) was cured, and the colostomy was closed. One patient (2.6%) developed rectal mucosal damage after the second application.

Conclusion: A 4-min application of 4% formalin for hemorrhagic radiation-induced proctopathy under perianal anesthetic infiltration in patients who have received external radial radiation therapy for prostate cancer is simple, reasonably safe, inexpensive, generally well tolerated, and effective.

Keywords: Formalin application; Prostate cancer; Radiation proctopathy; Rectal bleeding.

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