Underlying functional bowel disorder may explain patient dissatisfaction after haemorrhoidal surgery

Area of Science:

• Colorectal Surgery
• Patient Outcomes Research
• Gastroenterology

Background:

• Haemorrhoid surgery outcomes often focus on technical success, with less emphasis on patient-reported dissatisfaction and functional symptoms.
• Understanding long-term patient satisfaction is crucial for improving surgical care and patient quality of life.

Purpose of the Study:

• To evaluate patient dissatisfaction and functional symptoms after haemorrhoid surgery.
• To identify factors associated with dissatisfaction following Milligan-Morgan haemorrhoidectomy and stapled haemorrhoidopexy.

Main Methods:

• A prospective study involving 359 patients who underwent either Milligan-Morgan haemorrhoidectomy (n=205) or stapled haemorrhoidopexy (n=154).
• Self-administered questionnaires assessed patient satisfaction and functional symptoms at a median follow-up of 59 months.
• Logistic regression analysis identified predictors of dissatisfaction.

Main Results:

• A 72% response rate was achieved, with 13.6% of patients reporting dissatisfaction.
• Dissatisfied patients were more likely to be female and have a history of constipation and irritable bowel syndrome.
• Persistent anal pain was the predominant symptom associated with dissatisfaction, occurring in 91% of dissatisfied patients compared to 55% of satisfied patients (P<0.001).

Conclusions:

• Persistent anal pain is the major long-term factor linked to patient dissatisfaction after haemorrhoid surgery.
• Functional symptoms like incontinence and constipation were also significantly higher in dissatisfied patients.
• Addressing long-term pain management is critical for improving patient satisfaction post-haemorrhoid surgery.