Clinical characteristics of patients with prolapsing haemorrhoidal disease

Hemorrhoidal disease (HD) affects 4,4 to 86% of the general population, peaking between age 45 to 65 years. Surgical treatment is indicated for HD grade III and IV. Surgery includes excisional hemorrhoidectomy following MilLīgan-Morgan or Ferguson's recommendations. Longo technique allows avoiding tissue trauma, severe pain, bleeding, and post-operative mucosal discharge characteristic of conventional hemorrhoidectomies. LīgaSureTM vessel sealing system allows reduction of anal spasm and pain after excisional operations. Medical records of 39 female patients (under (the 1st group ‒G1) and over (the 2nd group ‒ G2) 45 years of age) with HD grade III and IV treated between September and November 2020 at Pauls Stradins Clinical University Hospital are being analyzed retrospectively. Twenty of 39 (51%) women (median age ‒ 35.45) constituted G1, whereas 19 (49%) ‒ G2 (median age ‒ 65.26). Pain and discomfort in the anal area were common complaints 13 (68.4%). Bleeding was found in 16 (80%) and 9 (47.4%) cases for the G1 and G2, respectively. Perianal mass and mucosal prolabation were reported in 14 (70%) and 8 (42.1%) cases specified for G1 and G2, respectively, whereas defecation disorders ‒ in more than 1/2 of G1 ‒ 11 (55%) when compared to six cases in G2. G1 women exclusively complained about difficulties performing personal hygiene in 6 (30%) cases. Longo hemorrhoidectomy was used in 15 (75%) and 10 (52.7%), MilLīgan-Morgan ‒ 3 (15%), and 6 (31.6%) cases for G1 and G2, respectively, whereas LīgaSureTM ‒ in two G2 patients, Ferguson ‒ in 9 (10%) and 1 (1.3%). Bleeding and defecation disorders are pathophysiology-related complaints. The etiology-based Longo technique is the most suitable treatment of HD.