Transient sphincter dysfunction due to bruising may occur but gets better with time. If occasionally stretching is overdone perineal muscle exercises would put it right - occasional tear of the anus can be stitched and it would heal even if left alone. There are no disheartening problems. Various studies have found the pressure changes that last and are beneficial to the defaecation reflex and process of evacuation and help in the prevention of recurrence. No body knows who invented this but it has lasted over a 100 years.
Phenol is good sclerosant.
It has been found good in the treatment of oesophageal varices. An oblique ended, short, wide proctoscope, which would allow only one pile on view at a time. Careful submucous injections in the middle of the pile are carried out in all piles. 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.