The solution spreads in the submucous area of the pile but does not spread all over the circumference because of septa between the piles. Basically at 3,7 and 11 o'clock position but may have to be injected in between. The pile area gets swollen to a translucent, tense, shining ring. Pack is not left in. Commercially available needles have a very thin lumen and oil does not flow easily.
Mucosa is lifted with the angled needle and short bevel and the fluid injected.
Average pile needs approx. Very occasionally the thrombotic nodules last longer and are palpable for sometime. Proteolytic enzymes and anti-inflammatory agents are helpful in such situations. Occasional bleeding is easily controlled with oral ethamsylate. Additional features Hypertrophied papillae are cauterized.