Radiofrequency for Hemorrhoids
Radiofrequency for hemorrhoids. Bleeding and prolapse addressed in a single ambulatory session.
Radiofrequency treatment for hemorrhoidal disease at Palazzo Manzoni in Brescia, performed by Prof. Edoardo Cervi. Controlled radiofrequency energy applied to the hemorrhoidal tissue addresses both bleeding and prolapse. Ambulatory, no general anaesthesia, same-day return to daily activity.
Radiofrequency treatment for hemorrhoidal disease at Palazzo Manzoni in Brescia is performed by Prof. Edoardo Cervi, general and vascular surgeon. Controlled radiofrequency energy is delivered to the hemorrhoidal tissue through a fine probe, producing a coagulation effect that addresses both bleeding and prolapse. The procedure is ambulatory, takes 15 to 30 minutes, does not require general or spinal anaesthesia, and is followed by same-day return to daily activity.
Bleeding and prolapse, both addressed
A single procedure for both symptoms.
Ambulatory
No general or spinal anaesthesia.
15 to 30 minutes
Then home.
Same-day return to your life
Office work, walking, normal activity.
Why Radiofrequency, Alongside Foam
Two techniques, one consultation, the right answer for your picture.
Hemorrhoidal disease is not a single condition with a single technique. The grade, the pattern of symptoms (bleeding-dominant, prolapse-dominant, mixed), the size of the cushions, the presence of an external component, and the patient’s history all shape the choice of technique.
Foam endosclerosis is the workhorse for grade I to II bleeding-dominant disease. Radiofrequency is particularly useful for selected grade II to III pictures with reducible prolapse, where the controlled coagulation of the tissue addresses both the bleeding and the structural component in a single session.
The two techniques are not in competition. They are complementary tools in the same hand, chosen by indication. The first consultation establishes which technique fits your specific picture, or whether the two can be combined.
What Radiofrequency Actually Does
A controlled application of energy to the hemorrhoidal tissue
Radiofrequency, in this clinical setting, is a controlled application of electromagnetic energy delivered through a fine probe in direct contact with the hemorrhoidal tissue. The energy produces a localised coagulation effect: the small vessels inside the cushion are sealed, the tissue retracts, and the structural component of the prolapse is addressed.
The technique is performed under direct vision through an anoscope, with the operator placing the probe precisely on the area to be treated. The procedure is brief, the immediate effect is visible, and the recovery is measured in days.
Unlike foam endosclerosis, which closes the diseased vessel chemically by injecting a sclerosing foam, radiofrequency produces a controlled coagulation of the tissue. Foam is typically the workhorse for grade I to II bleeding-dominant disease; radiofrequency is particularly useful for grade II to III mixed pictures with reducible prolapse. The two techniques are complementary.
01
Both symptoms, one session
The controlled coagulation addresses both bleeding and prolapse.
02
Placed under direct vision
The probe is placed precisely on the area to be treated, through an anoscope.
03
No anaesthesia, no incision
Ambulatory, 15 to 30 minutes, performed by Prof. Edoardo Cervi.
How It Works, Step By Step
From consultation
to same-day return.
Step 01
Proctological consultation
A focused history, an examination, and anoscopy or rectoscopy where indicated. The disease is graded. The clinical picture (bleeding-dominant, prolapse-dominant, mixed) is established. Other causes of rectal symptoms are excluded.
Step 02
The plan
You leave the first visit with a clear recommendation: foam endosclerosis, radiofrequency, both in combination, or in the minority of advanced cases, a surgical option discussed with the appropriate context.
Step 03
The procedure
Ambulatory. The patient is positioned. The anoscope is introduced. The radiofrequency probe is placed on the area to be treated, and the controlled application of energy is delivered. Total procedure time, 15 to 30 minutes. No general or spinal anaesthesia.
Step 04
Same-day return
Return home within the hour. Normal daily activity, including office work, from the same day. Pain, where present, is mild and well controlled with standard analgesics.
Who Radiofrequency Is For
Is radiofrequency
right for your picture?
Radiofrequency is particularly useful where bleeding and prolapse coexist, but the match matters. The grade, the symptom pattern and the anatomy, established at the consultation, determine whether it fits. Most candidates share several of the following.
Clinical profile
- Grade II to III hemorrhoidal disease with reducible prolapse
- Mixed bleeding-and-prolapse pictures where a single technique can address both components
- Selected cases where the anatomy or the symptom pattern is better suited to radiofrequency than to foam
- Patients who have responded partially to foam endosclerosis and require a complementary approach
- No acute thrombosed external hemorrhoid and no active inflammatory bowel disease in flare
- Not pregnant and not in the immediate postpartum period
Patient profile
- Patients who specifically wish to avoid the classic surgical operation
- Those whose symptoms mix bleeding and prolapse and who want both addressed at once
- Those who want a same-day return to office work and normal activity
- Those who prefer a procedure with no general or spinal anaesthesia
- Those open to a combined plan with foam endosclerosis where the picture calls for it
Where it isn’t the right answer?
Radiofrequency is not the answer for an acute thrombosed external hemorrhoid (a different acute clinical picture), for specific advanced grade IV pictures with fixed prolapse (where surgical options are discussed), during active inflammatory bowel disease in flare, or in pregnancy and the immediate postpartum. The procedure also does not address external hemorrhoidal components, which are managed separately where present.
If radiofrequency fits, your consultation will confirm it. If not, the right answer for your picture still exists, and the grading will find it. For selected mixed pictures, radiofrequency and foam endosclerosis can be combined in the same overall plan; the sequence is established at the consultation.
A Clean Ambulatory Technique
Two ambulatory techniques have replaced the classic operation
Radiofrequency and foam endosclerosis are the two ambulatory techniques that, for the substantial majority of patients today, have replaced the classic surgical operation. Radiofrequency for hemorrhoidal disease is the more recent of the two, with a clinical track record that continues to grow. The classic Milligan-Morgan hemorrhoidectomy remains the gold-standard surgical operation, but it is today reserved for the minority of advanced cases.
At Palazzo Manzoni, radiofrequency treatment is performed by Prof. Edoardo Cervi, general and vascular surgeon. The same specialist who carries out the consultation carries out the procedure. The choice between radiofrequency and foam is not a matter of preference; it is a matter of grade, clinical picture, and which technique fits which problem.
Day by Day
Same-day return, the first days, and the follow-up
The day of the procedure
Return home within the hour. Normal daily activity, including office work, from the same day. Pain, where present, is mild and well controlled with standard analgesics. Most patients return to office work the day of the procedure or the day after.
The first days
Mild discomfort, occasional small spotting, and a sense of pressure are normal. The controlled coagulation has addressed both the bleeding and the structural component of the prolapse; the tissue continues to settle.
The following weeks
Both the bleeding and the prolapse improve in most cases. Where multiple cushions are involved, additional sessions may be required for full resolution. For more complex pictures, two sessions four to six weeks apart may be planned.
Four to six weeks: follow-up
A control visit at four to six weeks confirms the response. One session is often sufficient; for more complex pictures, a second session may be planned.
Honest Expectations
What radiofrequency
doesn’t do
Radiofrequency is a clean ambulatory technique. Honesty about its limits matters more than marketing.
One session is often sufficient. For more complex pictures, two sessions four to six weeks apart may be planned. Mild discomfort, occasional small spotting, and a sense of pressure are normal in the first days. The procedure does not address external hemorrhoidal components, which are managed separately where present.
Recurrence is possible if the contributing lifestyle factors are unchanged. A small minority of advanced cases will still benefit from a formal surgical operation. When this is the right answer, it is said clearly at the consultation.
Who Performs the Procedure
Prof. Edoardo Cervi
General and vascular surgeon, phlebology subspecialisation. Proctological consultation, radiofrequency, foam endosclerosis, elastic ligation.
General and vascular surgeon
with phlebology subspecialisation; hemorrhoidal disease treated as the venous problem it is
Radiofrequency
controlled energy that addresses both bleeding and prolapse in a single session
Foam endosclerosis
the complementary ambulatory technique, the workhorse for bleeding-dominant grades
Elastic ligation
a further complementary technique for specific grade II to III pictures
One specialist, start to finish
the same specialist who carries out the consultation carries out the procedure
“Radiofrequency and foam endosclerosis are the two ambulatory techniques that, for the majority of patients today, have replaced the classic operation. The choice between them is not a matter of preference; it is a matter of grade, of clinical picture, and of which technique fits which problem. The conversation in 2026 is no longer ‘will I have surgery’ but ‘which of the two ambulatory techniques fits my specific picture.’”
Patient Stories
They were where
you are now
Bleeding and prolapse together, addressed in a single ambulatory session. The starting point is often the same: the expectation of an operation that, today, rarely comes.
In their own words
“The prolapse had become a daily problem. I was expecting to be told the operation was the only answer. Prof. Cervi proposed radiofrequency. Ambulatory. The difference was immediate.”
“Bleeding and a prolapse that I’d worked around for years. One thirty-minute visit, no anaesthesia, and both improved together. I was back at my desk the next morning.”
“I’d had a partial response to a previous treatment. Prof. Cervi explained how radiofrequency could address what remained. One session, and the symptoms that had lingered finally settled.”
Options
If radiofrequency isn’t the whole answer, there is a technique that fits
Radiofrequency is particularly useful for selected grade II to III pictures with reducible prolapse. But the grade, the symptom pattern and the anatomy all shape the choice, and another technique sometimes fits better, or complements it.
The techniques are not in competition. They are complementary tools in the same hand, chosen by indication, and in selected mixed pictures combined in a single plan.
→Foam endosclerosis
The workhorse for grade I to II bleeding-dominant disease — the cushion retracts during the procedure itself.
→Elastic ligation
A small elastic band placed at the base of the cushion under anoscopy, complementary for specific grade II to III pictures.
→Milligan-Morgan hemorrhoidectomy
The classic surgical operation, reserved today for the minority of advanced cases unsuitable for minimally invasive techniques.
Your proctological consultation will clarify which path, or combination, is right.
Common Questions
Common questions
about radiofrequency for hemorrhoids
How is radiofrequency different from foam endosclerosis?
Foam endosclerosis closes the diseased vessel chemically by injecting a sclerosing foam into the hemorrhoidal cushion. Radiofrequency produces a controlled coagulation of the tissue through a fine probe in contact with the cushion. Foam is typically the workhorse for grade I to II bleeding-dominant disease; radiofrequency is particularly useful for grade II to III mixed pictures with reducible prolapse. The two techniques are complementary.
Is the procedure painful?
The procedure is described by most patients as well tolerated. No general or spinal anaesthesia is required. Mild discomfort or a sense of pressure during and immediately after the procedure is normal.
How long does the procedure take?
The radiofrequency application is 10 to 15 minutes; the total visit, including anoscopy and dressing, is typically 30 to 40 minutes.
Will I need to repeat the treatment?
One session is often sufficient. For more complex pictures, two sessions four to six weeks apart may be planned. The exact answer is established at the consultation.
When can I return to my activities?
The same day. Most patients return to office work the day of the procedure or the day after.
Will both the bleeding and the prolapse improve?
Both, yes, in most cases. The controlled coagulation addresses both components. Where multiple cushions are involved, additional sessions may be required for full resolution.
Will I need a follow-up?
A control visit at four to six weeks confirms the response.
Can the disease come back after treatment?
Recurrence is possible if the contributing lifestyle factors are unchanged.
What about the classic surgical operation?
The Milligan-Morgan hemorrhoidectomy remains the gold-standard surgical operation, but it is today reserved for the minority of advanced cases.
How much does the procedure cost?
A clear, transparent estimate is provided after the first consultation.
Where is Palazzo Manzoni, and do I need a referral?
Istituto Chirurgico Palazzo Manzoni is at Via dei Mille 14 in central Brescia. No referral required.
Who performs the procedure?
Radiofrequency treatment for hemorrhoidal disease at Palazzo Manzoni is performed by Prof. Edoardo Cervi.
Take the Next Step
A 30-minute outpatient visit,
instead of an operation.
At Palazzo Manzoni in Brescia, your proctological consultation is thorough, honest, and conducted with the privacy and dignity the conversation deserves.
Address
Via dei Mille 14, 25122 Brescia, Italia
Phone
Hours
Mon-Fri 8:30-18:30 · Sat 9:00-13:00
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Get in touch
Call, email, WhatsApp, or book online.
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Be examined and graded by Prof. Cervi
A 20 to 30 minute visit, in privacy.
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Move forward, with a plan
A plan that for most patients is no longer surgical.
Content reviewed by Prof. Edoardo Cervi, head of Vascular Surgery.