Underlying functional bowel disorder may explain patient dissatisfaction after haemorrhoidal surgery

Colorectal Dis. 2012 Mar;14(3):356-61. doi: 10.1111/j.1463-1318.2011.02612.x.

Abstract

Aim: The aim of this study was to assess patient dissatisfaction and functional symptoms following haemorrhoid surgery, aspects of which are seldom covered in other published series.

Method: A self-administered questionnaire was mailed to 359 consecutive patients (prospective database; 198 men, 161 women; median follow up, 59 [1-120] months) who underwent either Milligan-Morgan haemorrhoidectomy (n=205) or stapled haemorrhoidopexy (n=154).

Results: The response rate was 72%; 2.4% of patients had no opinion, 13.6% were dissatisfied, 33.0% were satisfied, and 51.0% were very satisfied with the treatment. Dissatisfied patients were more likely to be women and more likely to have a long history of constipation and irritable bowel syndrome. The duration of surgery and the rates of pre- and postoperative complications did not differ between groups. Residual bleeding (49% vs 32%), prolapse (67% vs 31%) and pain (91% vs 55%) occurred more frequently in the dissatisfied group compared with the satisfied group (P<0.001). Incontinence (4 [0-16] vs 1 [0-15]; P=0.0003) and constipation (19 [1-34] vs 8 [0-31]; P<0.0001) scores were significantly higher in the dissatisfied group compared with satisfied patients. Anal pain was the predominant symptom associated with dissatisfaction in a logistic regression model.

Conclusion: Persistent pain remains the major long-term factor associated with dissatisfaction after surgery for haemorrhoids.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Constipation / complications*
  • Fecal Incontinence / complications*
  • Female
  • Follow-Up Studies
  • Hemorrhoids / complications
  • Hemorrhoids / surgery*
  • Humans
  • Irritable Bowel Syndrome / complications*
  • Logistic Models
  • Male
  • Middle Aged
  • Pain, Postoperative
  • Patient Satisfaction / statistics & numerical data*
  • Preoperative Period
  • Retrospective Studies
  • Self Report