How to Perform Anoscopy

• Indications:
  • Anal lesions (fistulas, tumors, etc.)
  • Rectal bleeding
  • Rectal pain
  • Banding or injection of hemorrhoids
• Contraindications:
  • Anal stricture
  • Acute perirectal abscess
  • Acutely thrombosed hemorrhoid
• Anesthesia:
  None
• Equipment:
  • Clear polyethylene anoscope
  • Water-soluble lubricant
  • Directed light source or head-light
• Positioning:
  Lateral decubitus position or lithotomy position
• Technique:
  • Examine anus by gently spreading anoderm and performing digital rectal examination.
  • Insert the anoscope slowly, using a liberal amount of lubricant and with the obturator in place, until the flange at the base rests on perianal skin.
  • Remove the obturator, and while withdrawing the anoscope, examine the anal mucosa in a systematic manner.
  • Repeat the procedure as needed to ensure full inspection of the anal canal.
• Complications and Management:
  • Fissure
    • Anal or perianal tears may occur and usually respond to conservative measures.
    • Bleeding
    • Unusual, but may occur especially in the setting of large internal hemorrhoids; usually self-limited.