Dr Rajiv Manek

Circumcision is a surgical procedure that involves the removal of the foreskin, a fold of skin covering the head (glans) of the penis. This procedure has been practiced for thousands of years and is performed for various reasons, including cultural, religious, medical, and personal preferences. Here are some key points about circumcision:Cultural and Religious Practices: Circumcision is a common cultural or religious practice in many communities around the world. For example, it is a significant religious rite in Judaism and Islam. In these traditions, circumcision is often performed shortly after birth or during early childhood.Medical Reasons: Circumcision may be recommended for certain medical reasons, including:Phimosis: This is a condition where the foreskin is too tight and cannot be retracted, making it difficult to clean the penis. Circumcision can alleviate this issue.Recurrent Infections: Some individuals may experience frequent infections under the foreskin, which can lead to discomfort and health concerns. Circumcision can reduce the risk of these infections.

Hemorrhoids, also known as piles, are swollen veins located around the rectum or in the anus. They can cause discomfort, pain, bleeding, and itching. Hemorrhoids are a common condition and can be caused by various factors, including straining during bowel movements, chronic constipation or diarrhea, pregnancy, obesity, and a family history of hemorrhoids.Here are some key points about hemorrhoids:Types of Hemorrhoids:Internal Hemorrhoids: These are located inside the rectum and are typically painless. They may cause bleeding during bowel movements.External Hemorrhoids: These are located under the skin around the anus. They can be painful and itchy, and sometimes a blood clot can form within them, causing a condition called a thrombosed hemorrhoid.

What is the best treatment for anal fissure?Anal Fissure is common. The good news is that the majority of patients can be treated medically without the need for a procedure or surgery. Dr. Rajiv believes in customizing the care according to the needs of the patient. He recommends to each patient what is best based on a personalized approach. Dr. Rajiv advises a procedure or an operation when the symptoms are very severe, recurrent, or for patients who do not improve with medications. When an intervention is needed, a minimally invasive procedure is considered for patients who can benefit from it.What are the benefits of minimally invasive procedures for anal fissure?Minimally invasive procedures yield many benefits including less pain, faster recovery, and earlier return to work. Some interventions are done in the office without the need for hospitalization and patients can return to work the day following office based procedures. For procedures performed in the operating room, most patients go home within 24 hours of the procedure and are back to work within 1 week.What are minimally invasive procedures for anal fissure?There are 2 types of minimally invasive procedures for anal fissure:Office based interventions. Anal dilation and Botox® injection can be performed in the office. The goal is to gently stretch and relax the anal muscle to allow the fissure to heal. The risks are minimal. Post-procedural care includes Sitz Bath for 1 to 2 days, acetaminophen pills (Tylenol, Adol, Panadol) if any discomfort, and keeping the stool soft with High Fiber Food and Fiber Supplements.Operating room procedures. For some patients Botox® injection into the muscle is done in the operating room along with scraping of the fissure (fissurectomy). Prednisone injection into the fissure area is an alternative procedure that can be performed along with anal dilation. Laser fissure treatment is another option for some patient.