Receiving A High resolution anoscopy (HRA)

Your routine hygiene measures are all that is necessary. The anal canal does not contain any faecal material, unless you actively want to go to the toilet.

The procedure itself typically takes around 15-30 minutes. It is performed in a specially equipped, private room. We will ask you to remove the lower half of your clothes and then give you a gown. Using lubricant mixed with local anaesthetic, a small tube (proctoscope) is inserted into the anus and then special dyes are introduced. The specialist will then look inside, using a high powered microscope. If you want to, you can watch what is happening on the television screen. If there are abnormalities present, an internal anal biopsy may be recommended.

A biopsy is a small sample of tissue that is sent to the laboratory for analysis. It is removed from inside the anus using special tweezers. Most people undergoing internal anal biopsies do not feel anything, but there may be some discomfort or pain. The doctor will let you know when this is about to happen. It is quite common for several biopsies to be taken.

As part of the HRA assessment, the doctor will also carefully examine the outside edge of the anus (the perianal skin). If any abnormalities are seen, then a biopsy will be recommended. Local anaesthetic will be used for this, and frequently a stitch will be used, to promote rapid healing. Stitches are then generally removed 5-7 days later.

The doctor will provide you with information about what you should do and what you should avoid in the days after the HRA. There may be slight bleeding for 24-48 hours after the procedure. It is recommended that you do not do anything strenuous (such as going to the gym or swimming) on the day of the procedure. For the following week, you are advised not to have receptive anal intercourse or to use anal toys. Healing of the biopsy sites occurs very quickly, usually without any scarring. All procedures are done using sterile or single-use equipment. Infections are very rare, as the lining of the anus has a very strong immune system.

You will be informed of the results of the results within one month. At that time, you be asked to complete a brief survey about your experiences of the HRA procedure. Depending on what is found at the HRA, you may be asked to return to discuss any treatments or further follow up.