Redo procedure for prolapse and haemorrhoids (PPH) for persistent and recurrent prolapse after PPH

Procedures for haemorrhoidal prolapse that maintain functional haemorrhoidal anatomy are progressively used. The procedure for prolapse and haemorrhoids (PPH) has advantages over conventional haemorrhoidectomy, but is associated with a higher recurrence rate. The feasibility and efficiency of a second PPH instead of haemorrhoidectomy in case of recurrent symptoms were studied.

A retrospective chart review was conducted of all patients that were treated with PPH for haemorrhoidal prolapse in our hospital between May 2002 and November 2008. All patients in need for a second PPH because of persistent or recurrent symptoms of prolapse were identified and analyzed.

Out of 137 patients who underwent a PPH, 22 patients (16%) were in need of a reoperation for symptoms of prolapse. Of these, 12 (55%) were treated with a second PPH. Successful prolapse reduction was achieved in 11 out of 12 patients. No postoperative complications were encountered during a median follow-up of 35 months.

Redo PPH, in case of persisting or recurrent symptoms of haemorrhoidal prolapse after PPH, is feasible and is a good alternative for excisional haemorrhoidectomy. It possesses the same advantages over haemorrhoidectomy as the initial PPH and does not lead to more morbidity.