Rafaelo Radio Frequency
for Haemorrhoids/Piles

The Rafaelo procedure is highly effective for Grade II and Grade III internal haemorrhoids. It is specifically designed to treat prolapsed piles (piles that push out) and chronic bleeding piles without the need for painful surgery or a hospital stay.

The procedure itself is not painful because the radio frequency probe targets tissue above the dentate line, where there are no pain-sensitive nerve receptors. It is performed comfortably under a local anaesthetic. Patients generally report feeling only a mild sensation of warmth or gentle pressure. Some mild aching or a feeling of fullness in the back passage is normal for a few days post-treatment and can be easily managed with over-the-counter painkillers.

Yes. Rafaelo uses radiofrequency energy to safely shrink Grade II and Grade III prolapsed piles. By restricting the blood supply to the haemorrhoid, the prolapsed tissue naturally shrinks and disappears within a few weeks, providing long-term relief from symptoms.

Yes, absolutely and there’s no need to be embarrassed if your piles are actively bleeding. In fact, stopping rectal bleeding is one of the primary reasons colorectal surgeons recommend the Rafaelo procedure.

Here is why it is so effective for bleeding piles:

• Instant Coagulation: The radiofrequency energy doesn’t just shrink the tissue; it uses controlled thermal heat to instantly coagulate and seal the blood vessels supplying the haemorrhoid. This acts like an internal switch, cutting off the source of the bleeding during the treatment.
• Targets the Root Cause: Bleeding happens when the fragile, engorged walls of internal piles (usually Grade II or III) are stretched and torn during bowel movements. By shrinking these vessels back to their normal size, Rafaelo prevents them from protruding and tearing.
• High Success Rate: Because it targets the internal vascular cushions directly, patients typically see a complete cessation of their regular bleeding symptoms within 1 to 2 weeks post-procedure as the area fully heals.

Yes, both rubber ligation (banding) or injection of sclerosant (Phenol) is an option should Rafaelo radio-frequency not be appropriate or surgery in severe cases.

On assessment, your colorectal consultant will discuss the best options for your haemorrhoid treatment.

As the Rafaelo procedure is a novel treatment and the evidence base for it is still being established, the National Institute for Health and Clinical Excellence (NICE) has recommended that it should be used with special arrangements for clinical governance, consent and audit.

At Cosmedics, we keep careful records of all Rafaelo cases performed and regularly audit our clinical outcomes for the procedure.

All treatments and procedures have risks. The most common risks post-procedure and during the following 2 weeks include discomfort, mild bleeding or spotting or anal discharge and faecal urgency in the first 48 hours. Other rarer post-procedure complications might include recurrence of symptoms, infection, ulceration, fissure, or significant bleeding/haemorrhage.

Your consultant will discuss the benefits and risks of The Rafaelo Procedure during your initial consultation.

Recovery is very quick compared to surgery, but many patients prefer to take a little time off work. You may only need 1-2 days for smaller haemorrhoids or 3-4 days for larger ones. We can advise on this at your appointment depending on the nature of your piles.

It’s generally advisable to avoid having treatment close to any key social and work events. Again, we can help you plan and choose a convenient date.

Yes, it is a common occurrence to have haemorrhoids in homosexual men.

It can be very embarrassing and awkward to have haemorrhoid symptoms. There is also the sexual health risk to consider due to the increased likelihood of bleeding during intercourse with haemorrhoids.

Haemorrhoid treatment is ideal for patients who just want to get back to normal daily lives as quickly as possible and not have to worry about it again.

Yes. During your initial consultation with our colorectal surgeons, a comprehensive evaluation will be performed. If you have both internal prolapsed piles and external anal skin tags (which are often caused by the stretching of previous piles), the surgeon can frequently treat the internal haemorrhoids using Rafaelo and remove the external skin tags during the same appointment for your comfort and convenience, or else in a separate appointment where that is preferable. We can also treat anal fissures. For more information:

• Anal skin tag removal
• Anal fissure treatment

For the vast majority of patients, a single Rafaelo treatment provides permanent relief from that specific haemorrhoid. Cosmedics achieves a success rate of over 90%. However, because the procedure treats existing piles, new haemorrhoids can theoretically develop in the future if underlying causes, such as chronic constipation, straining, or a low-fibre diet, are not addressed. Therefore it is always best to heed lifestyle advice alongside the treatment for best results.

Don’t be alarmed if you feel a strong sense of fecal urgency for the first 48 hours after a Rafaelo procedure, this is quite common. This happens because the treated, healing tissue temporarily mimics the sensation of a full bowel, tricking the nerves. This feeling is entirely normal, and the sensation naturally subsides within 2 days as the area begins to heal.

We find that in practice, 9 out of 10 people are very satisfied with the outcome of the procedure for treating haemorrhoids.

One in 10 feel that their haemorrhoid symptoms are not improved sufficiently afterwards. In these cases, the Rafaelo procedure can be repeated, or an alternative treatment like excision of remaining anal skin tags or traditional haemorrhoidectomy may be required.

Mr von Roon will advise you on this when you attend for the follow-up consultation after your haemorrhoid treatment.

For detailed information:

AFTERCARE LEAFLET