- GA
- Lloyd-Davis position
- Admixture: 10ml 1% Methylene blue, 2ml methylprednislone and 20ml 0.5% Bupivacaine
- Inject with 25 gauge needle into the intradermal and subcutaneous perianal and intra-anal skin
- Avoid injection too much in one bleb as can cause ulcers
- Avoid the transitional zone as can cause temporary incontinence
- Make sure it is idiopathic prior → 90% succesful