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Biopsy question

  • Tuesday, September 16, 2025 9:47 PM
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    Reply # 13542937 on 13540852
    Akira Kawahima

    Dear IANS Team,

    Thank you very much for organizing the Virtual Standard HRA Course — it has been an incredibly valuable learning experience.

    I would like to ask a question regarding the use of Lugol’s iodine solution in high-resolution anoscopy (HRA):

    • Does the concentration of Lugol’s iodine vary depending on the institution or practitioner?
    • If so, are there differences in diagnostic effectiveness based on the concentration used?

    I would be grateful if you could share any recommendations, standards, or published guidance regarding the preferred Lugol’s iodine formulation for anal HRA (e.g., 2%, 3%, 5%).

    Thank you for your time and support.

    Warm regards,

    Akira Kawashima

    PhD Program, Kumamoto University, Japan
  • Wednesday, September 10, 2025 12:05 PM
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    Reply # 13540855 on 13540852
    Anonymous member (Administrator)

    Yes - this is generally the preferred approach particularly because once you start performing biopsies you will also have to deal with bleeding, which makes the examination more difficult. We do not advocate biopsies as you go along as the bleeding will obscure the views.  Biopsies should be performed at the end starting with the most dependent area first so the blood does not get in the way.

    Cristina Brickman and Jessica Korman
  • Wednesday, September 10, 2025 12:04 PM
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    Message # 13540852
    Anonymous member (Administrator)

    Would you advise to biopsy the lesions as the anoscopy goes ahead to avoid the oedema from completing it and then go back for the biopsies?
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