Long-term manometric study of anal sphincter function after hemorrhoidectomy

Area of Science:

• Colorectal surgery
• Anorectal physiology
• Surgical outcomes

Background:

• Hemorrhoidectomy outcomes, particularly manometric changes, require further long-term investigation.
• Existing data on maximum resting pressure (MRP) and maximum squeeze pressure (MSP) post-hemorrhoidectomy are inconsistent.
• Short follow-up periods limit understanding of long-term functional recovery.

Purpose of the Study:

• To prospectively evaluate long-term (1-year) manometric results after Milligan-Morgan hemorrhoidectomy.
• To assess changes in maximum resting pressure (MRP), maximum squeeze pressure (MSP), and ultra slow wave activity (USWA).
• To compare post-surgical manometric data with preoperative values and healthy controls.

Main Methods:

• Prospective study involving 20 patients with third and fourth-degree hemorrhoids.
• Anorectal manometry performed preoperatively and at 5 days, 1, 6, and 12 months post-surgery.
• Comparison of manometric data (MRP, MSP, USWA) between patients and healthy controls.

Main Results:

• Ultra slow wave activity (USWA) transiently increased post-surgery, normalizing by 12 months.
• Maximum squeeze pressure (MSP) showed no significant change from baseline.
• Maximum resting pressure (MRP) initially increased, then normalized by 12 months, comparable to controls.

Conclusions:

• Milligan-Morgan hemorrhoidectomy effectively resolves preoperative manometric abnormalities.
• Excision of anal cushions results in only mild and temporary alterations in anal continence.
• Long-term follow-up confirms functional recovery after hemorrhoidectomy.