What is Surgical Associates?

Surgical Associates, is a multi-location surgical practice established in 1984, specializing in minimally invasive, in-office vascular, thoracic, and surgical care. Their board-certified surgeons treat conditions like uterine fibroids, osteoarthritic knee pain, peripheral artery disease, and vein disorders across Maryland, Washington D.C., and Virginia.

Where are Surgical Associates' office locations?

Surgical Associates has five locations: Camp Springs, MD (5801 Allentown Road, Ste 502); Silver Spring, MD (10750 Columbia Pike #220); Waldorf, MD (11370 Pembrooke Square); Reston, VA (1860 Town Center Drive, Ste 180); and Washington, D.C. (1160 Varnum Street NE, Ste 318). All locations can be reached at (240) 427-1630.

How do I book a consultation at Surgical Associates?

You can book a consultation by calling (240) 427-1630 or by visiting the online booking page at sacmd.com/contact. The team will guide you through the scheduling process and answer any questions before your visit.

What treatments does Surgical Associates offer?

Surgical Associates offers a range of minimally invasive procedures including: Uterine Fibroid Embolization (UFE), Genicular Artery Embolization (GAE) for knee pain, Laser Ablation and Vein Treatments, Angioplasty, Atherectomy and Stenting, Radiofrequency Ablation, General Surgery, Vascular Surgery, and Wound Care.

What is Uterine Fibroid Embolization (UFE)?

Uterine Fibroid Embolization (UFE) is a minimally invasive procedure that treats noncancerous uterine fibroids without surgery or general anesthesia. Tiny particles are injected through a small catheter to block blood flow to the fibroids, causing them to shrink over time. Most patients experience symptom relief within a few weeks to a few months. The procedure typically takes 60-90 minutes, is performed under sedation, and most women return home the same day.

Is Uterine Fibroid Embolization (UFE) painful?

Most patients experience mild to moderate cramping after UFE, which is well managed with medication provided by the care team. The procedure itself is performed under sedation to ensure comfort throughout.

How soon will I see results after UFE?

Many women notice symptom relief within a few weeks after UFE, with continued improvement over several months as the fibroids gradually shrink. Symptoms such as heavy bleeding and pelvic pressure typically reduce significantly during this period.

Will I need to stay overnight after UFE?

UFE is typically an outpatient procedure, and most patients go home the same day or after a short observation period. Recovery is faster than traditional fibroid surgery, with most patients resuming normal activities within a week or two.

Does UFE preserve fertility?

Yes. UFE is a uterus-sparing procedure, making it a safe option for women who wish to maintain fertility. The treatment targets fibroids while leaving healthy uterine tissue intact. Patients are encouraged to discuss their fertility goals with their provider during the consultation.

What is Genicular Artery Embolization (GAE)?

Genicular Artery Embolization (GAE) is a minimally invasive procedure used to treat chronic osteoarthritic knee pain. It works by reducing blood flow to the inflamed lining of the knee joint, which helps decrease pain and improve mobility. GAE is designed for patients who have not found sufficient relief from other treatments and want to avoid or delay knee replacement surgery.

What vascular conditions does Surgical Associates treat?

Surgical Associates treats a wide range of vascular conditions including peripheral artery disease (PAD), varicose veins, venous insufficiency, and arterial blockages. Treatment options include angioplasty, atherectomy, stenting, laser ablation, radiofrequency ablation, and wound care for vascular-related wounds.

Are Surgical Associates' procedures performed in-office or in a hospital?

Most procedures at Surgical Associates are performed in-office as outpatient treatments, allowing for faster recovery and convenience. Some cases may be performed at select partner hospitals depending on the complexity of the procedure. The team will advise you on the appropriate setting during your consultation.

How experienced are the surgeons at Surgical Associates?

Surgical Associates' surgeons are board-certified with decades of experience. Dr. Rodeen Rahbar is a board-certified vascular surgeon with over 20 years of experience, has performed more than 1,500 interventions, and is recognized as a Castle Connolly Top Doctor. He trained at the University of Michigan, Marshall University, and Allegheny General Hospital, and previously served as an Assistant Professor of Vascular Surgery at George Washington University.

How long has Surgical Associates been in practice?

Surgical Associates has been serving patients since 1984, bringing over 40 years of experience in surgical and vascular care. The practice has evolved over the decades to focus on minimally invasive treatments for knee pain, uterine fibroids, and vascular conditions while maintaining its strong surgical heritage.

How Long Do HAE Results Last? Durability, Follow-Up, and Long-Term Expectations

When patients consider HAE, one of the most important questions they ask is: how long will the results last? This is a fair and necessary question, and it deserves an honest, evidence-based answer, including an acknowledgment of what we know, what we’re still learning, and how durability compares to other hemorrhoid treatments.

What the Published Data Shows

The Falsarella RCT (12-month follow-up). The only published randomized controlled trial comparing HAE to hemorrhoidectomy followed patients for 12 months. In the HAE group, bleeding resolution was maintained in 12 of 14 patients (83.3%) at one year. Two patients (14%) developed recurrent symptoms requiring secondary hemorrhoidectomy, both with external hemorrhoid development and prolapse. The study demonstrated that HAE provided durable symptom control for the majority of patients through the first year.

The Bagla retrospective series (134 patients, 2023). This larger cohort study reported 93% clinical success (defined as symptom improvement without additional treatment) at one month, with significant improvements in hemorrhoid symptom score, pain, quality of life, and bleeding scores, all statistically significant (P < .01). While this study focused on short-term outcomes, the high initial success rate provides a strong baseline for durability assessment.

Frontiers in Surgery review (2024). A comprehensive review of nearly 250 HAE patients across multiple studies reported clinical success rates ranging from 63% to 94%, with variation attributable to differences in patient selection, embolic technique, hemorrhoid grade, and follow-up duration. No major complications were reported across the entire literature.

What’s still being studied. Multi-year follow-up data (2+ years) for HAE is limited. Several ongoing clinical trials, including the UCLA HELIOS trial, will provide longer-term durability data as their follow-up periods mature. This is an honest limitation of the evidence base: HAE is a newer procedure than hemorrhoidectomy, and the long-term data is still accumulating.

How HAE Durability Compares to Other Treatments

No hemorrhoid treatment provides permanent immunity from recurrence. Hemorrhoidal disease has a biological predisposition: the vascular cushions that become symptomatic are normal anatomical structures influenced by genetics, diet, bowel habits, and aging.

Rubber band ligation has recurrence rates of 10–50% depending on hemorrhoid grade and follow-up length. Most studies show that approximately 30% of banded patients require repeat treatment within five years.

Surgical hemorrhoidectomy has the lowest published recurrence rate, approximately 5–10% over five or more years, because it physically removes the hemorrhoidal tissue. However, even surgery is not permanent; new hemorrhoidal tissue can develop from the residual vascular cushions.

HAE falls between banding and surgery in terms of current durability data. The 14% retreatment rate in the Falsarella RCT at one year is lower than banding but higher than surgery. As longer-term data accumulates, this comparison will become more precise.

Maximizing Durability: What You Can Do

The most effective strategy for extending the durability of any hemorrhoid treatment, including HAE, is lifestyle optimization. Maintain fiber intake of 25–30 grams daily. Stay well hydrated (at least 64 ounces of water daily). Avoid prolonged sitting on the toilet. Don’t strain during bowel movements. Respond promptly to the urge to defecate. Maintain a healthy weight.

These measures don’t just support HAE results: they address the underlying factors that cause hemorrhoidal disease in the first place. Patients who maintain healthy bowel habits after HAE are significantly more likely to enjoy lasting results.

Frequently Asked Questions

Q: How long do HAE results last?

A: The Falsarella RCT showed sustained symptom control through 12 months. The larger Bagla retrospective series (134 patients) reported 93% clinical success at one month. Longer-term data (2+ years) is still accumulating from ongoing studies.

Q: What is the retreatment rate after HAE?

A: In the Falsarella RCT, approximately 14% of HAE patients (2 of 14) required secondary hemorrhoidectomy within 12 months. In larger cohort studies, retreatment rates vary from 6–15% depending on follow-up length and disease severity.

Q: If HAE wears off, can it be repeated?

A: Yes. HAE can be repeated if symptoms recur. The procedure does not create scar tissue or structural changes that would prevent re-treatment.

Q: Is HAE as durable as surgical hemorrhoidectomy?

A: Hemorrhoidectomy has the longest track record (5–10% recurrence over 5+ years). HAE has less long-term data but shows promising durability in published studies. Both treatments can experience recurrence because the underlying predisposition to hemorrhoidal disease persists.

Q: What can I do to make HAE results last longer?

A: Maintain adequate fiber intake (25–30g daily), stay well hydrated, avoid prolonged straining, and practice healthy bowel habits. Lifestyle optimization is the single best strategy for extending the durability of any hemorrhoid treatment.

The Follow-Up Schedule at SACMD

At Surgical Associates, HAE follow-up typically includes a one-month post-procedure check (symptom assessment, initial response evaluation) and a three-month follow-up (full response assessment, comparison to pre-procedure symptoms). Additional follow-up is scheduled as needed based on symptom trajectory.

If symptoms recur, the options include optimized conservative management (fiber, hydration, bowel habits), repeat HAE (the procedure can be performed again, sometimes targeting additional vessels like the middle rectal artery), or escalation to hemorrhoidectomy if prolapse or tissue bulk is the dominant issue.

The key message: HAE is not a one-chance procedure. It preserves all future treatment options and can be part of a long-term management strategy.

Schedule a consultation: Call (240) 427-1630 or visit www.sacmd.com

Disclaimer: This article is for informational purposes only and does not constitute medical advice.

References:

Falsarella PM, et al. HAE vs Hemorrhoidectomy RCT. JVIR. 2023;34:736-744.
Bagla S, et al. Retrospective Analysis of 134 HAE Patients. JVIR. 2023.
Frontiers in Surgery. Hemorrhoidal Disease: Role of Rectal Artery Embolization. 2024.
UCLA HELIOS Trial. NCT07179601. ClinicalTrials.gov.
Cleveland Clinic. Hemorrhoid Treatment: Long-Term Outcomes.