title: Recurrent symptoms after stapled haemorrhoidopexy and the impact on patient satisfaction after a minimum of 2 years follow-up.
abstract: BACKGROUND
  Stapled haemorrhoidopexy came as an attractive alternative to treat grade 3 haemorrhoids. This study aims to assess the nature of recurrent symptoms and the impact on patient satisfaction after a minimum follow-up of two years in a group of patients who underwent stapled haemorrhoidopexy.
  
  
  METHODS
  A standardized questionnaire was used to evaluate a consecutive group of patients by telephone treated by a stapled haemorrhoidopexy between January 2004 and December 2007. Outcome assessment comprised residual symptoms, subsequent treatment, and patient satisfaction.
  
  
  RESULTS
  Hundred sixty-five patients underwent a stapled haemorrhoidopexy in the study period. Twenty-five patients (15%) were lost to follow-up. The included 140 patients presented with grade 2 (16) or grade 3 (124) prolapsing internal haemorrhoids. Median age was 50 years (range 27-79) and 56% were males. Median follow-up was 43 months (range 25-87). At final follow-up, 79 patients (56%) remained symptom-free. Nevertheless, 89% were more than satisfied. Only 11% were disappointed with the ultimate outcome. Recurrent symptoms were prolapse (52 patients), anal bleeding (46 patients), anal pressure or pain (24 patients) and pruritus (21 patients). Thirty-five patients had subsequent therapy: 20 underwent surgical resection and 15 had sclerotherapy or rubber band ligation. Patient satisfaction correlates with the number of recurrent (residual) symptoms and the need for further treatment.
  
  
  CONCLUSIONS
  Despite the high symptomatic recurrence rate after stapled haemorrhoidopexy, 89% of patients were satisfied. This suggests that recurrent or residual symptoms after stapled haemorrhoidopexy are often less severe compared to the initial presenting symptoms.
authors: Department of Abdominal Surgery, University Hospital Gasthuisberg, Leuven, Belgium. albert.wolthuis@uzleuven.be
authors: A M
authors: AM
authors: Wolthuis
authors: F
authors: F
authors: Penninckx
authors: J B
authors: JB
authors: Cornille
authors: S
authors: S
authors: Fieuws
authors: A
authors: A
authors: D'Hoore
mesh_terms: D000328:Adult; D000368:Aged; D013505:Digestive System Surgical Procedures / Q000379:methods / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011391:Prolapse; D012008:Recurrence; D017792:Surgical Stapling