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Updated: Jun 22, 2026

Invasive Hemodynamic Characterization of the Portal-hypertensive Syndrome in Cirrhotic Rats
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Is there a post-PPH syndrome?

I Khubchandani1, M H Fealk, J F Reed

  • 1Department of Surgery, Division of Colorectal Surgery, Lehigh Valley Health Network, Allentown, PA 18105-1556, USA. sally.lutz@lvh.com

Techniques in Coloproctology
|June 2, 2009
PubMed
Summary
This summary is machine-generated.

The Procedure for Prolapse and Hemorrhoids (PPH) is widely used, but concerns persist regarding long-term efficacy and complications like persistent pain and bleeding, with many reporting a "post-PPH syndrome".

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Area of Science:

  • Colorectal Surgery
  • Surgical Outcomes
  • Gastroenterology

Background:

  • Early studies suggested PPH reduces postoperative pain and morbidity compared to traditional hemorrhoidectomy.
  • Uncertainty remains regarding PPH's long-term efficacy and potential complications.
  • This study aimed to evaluate PPH usage prevalence and associated postoperative issues.

Purpose of the Study:

  • Assess the prevalence of PPH utilization among colorectal surgeons.
  • Identify and quantify postoperative complaints and complications following PPH.
  • Investigate the long-term outcomes and patient-reported syndromes associated with PPH.

Main Methods:

  • A questionnaire was distributed to national and international members of the American Society of Colon and Rectal Surgeons (ASCRS).
  • Data from 754 respondents (28.5% response rate) were analyzed.
  • Surgeons reported their experience with and continuation of PPH procedures.

Main Results:

  • Over 70% of respondents had performed PPH, with most continuing its use.
  • Delayed postoperative pain was the most frequent complaint, with 15.1% experiencing pain lasting months.
  • Persistent bleeding affected 34.5%, and 40.9% recognized a
  • post-PPH syndrome
  • .

Conclusions:

  • A majority of surgeons continue to perform PPH despite concerns.
  • Nearly half of PPH users acknowledge a
  • post-PPH syndrome
  • characterized by morbidities.
  • Persistent perineal pain and bleeding distal to the staple line present management challenges and question PPH's permanent efficacy.