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Long-term results of haemorrhoidectomy
Helgi O Jóhannsson1, Wilhelm Graf, Lars Påhlman
1Department of Surgery, Falu District Hospital, Falun, Sweden. helgi-orn.johannsson@ltdalarna.se
Objective:
To assess the long-term functional results of Milligan-Morgan haemorrhoidectomy.
Design:
Retrospective multicentre study.
Setting:
One university hospital, one county hospital, and two community hospitals, Sweden.
Subjects:
507 of 556 patients who were operated on for haemorrhoids by the Milligan-Morgan technique between January 1987 and December 1995.
Intervention:
A questionnaire was sent to all 507 patients, the questions in which focused on functional results and satisfaction.
Main Outcome Measures:
Patients' satisfaction and symptoms of anal incontinence after haemorrhoidectomy.
Results:
418 of the 507 responded (82%). Altogether 279 patients (67%) reported a successful result, while 139 patients (33%) reported impaired anal continence. 40 of the 139 patients (29%) claimed that the incontinence was a direct result of the haemorrhoidectomy. Female sex (p = 0.005) and an operation for hygienic problems (p = 0.02) were associated with a higher risk of incontinence.
Conclusion:
Impaired anal continence is common after Milligan-Morgan haemorrhoidectomy and a large proportion of affected patients relate their problems to the operation.