Less postoperative pain and more frequent recurrence: Can this dilemma caused by the stapled haemorrhoidopexy procedure be avoided?

Background Although early studies highlighted the advantages of stapled haemorrhoidopexy (SH) (minimal pain and a rapid return to work), long‐term follow‐up revealed that residual skin tags, external prolapsed haemorrhoids and recurrence were frequent. The aim of our study was to investigate whether the above‐mentioned problems could be prevented by performing additional interventions (AIs) during SH. We compared SH with and without AIs in terms of pain, wound‐healing time, patient satisfaction and recurrence. Methods A total of 106 patients with Grade III‐IV haemorrhoids diagnosed between 2016 and 2018 were included. There were four subgroups: Grade III‐IV patients undergoing SH alone or SH + AI. Results Subgroup 1 (Grade III; SH alone) showed significant decreases in the visual analogue scale pain scores on days 1 and 15 (P = .004), but no significant decreases were found in subgroups 2‐4 (P = .839, P = .092, and P = .781, respectively). Satisfaction was highest in subgroup 1 (4.22 ± 1.01), but there was no significant difference in satisfaction among the subgroups (P = .323). The overall recurrence rate was 13.2% and the difference among subgroups was significant (P = .023). Conclusions Depending on the haemorrhoid characteristics, the use of more than one repair method provides the best results. Although AIs increase pain and wound‐healing time, patient counselling enhances long‐term satisfaction and success.