Related Experiment Video
Updated: Dec 14, 2025
Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction
Published on: March 24, 2023
A New Classification for Hemorrhoidal Disease: The Creation of the "BPRST" Staging and Its Application in Clinical
Carlos Walter Sobrado Júnior1, Carlos de Almeida Obregon1, Afonso Henrique da Silva E Sousa Júnior1
1Discipline of Coloproctology, Division of Digestive Surgery, Department of Surgery, University of São Paulo Medical School, São Paulo, Brazil.
Insights
A new BPRST classification for symptomatic hemorrhoids shows promise in guiding treatment decisions for both internal and external components, potentially reducing management discrepancies compared to the Goligher classification.
Area of Science:
- Proctology
- Surgical Classification Systems
- Gastroenterology
Background:
- Symptomatic hemorrhoids require effective classification for appropriate management.
- Existing classifications may not fully address both internal and external hemorrhoid components or recent treatment advancements.
Purpose of the Study:
- To present an updated classification for symptomatic hemorrhoids, termed the BPRST classification.
- To guide treatment for both internal and external hemorrhoid components, incorporating new therapeutic options.
Main Methods:
- Development of the BPRST classification over seven years.
- Retrospective analysis of 149 patients treated between March 2011 and November 2013.
- Evaluation of the association between Goligher classification and the proposed BPRST classification with management strategies.
Main Results:
- Both Goligher and BPRST classifications demonstrated a statistically significant association with adopted management strategies.
- The BPRST classification exhibited fewer management discrepancies when individual disease stages were analyzed.
Conclusions:
- Revision of hemorrhoid classification is widely acknowledged as necessary.
- The BPRST classification shows a strong correlation with appropriate management for each disease stage.
- Further validation studies are recommended, with current findings being encouraging.
Purpose:
Present an updated classification for symptomatic hemorrhoids, which not only guides the treatment of internal hemorrhoids but also the treatment of external components. In addition, this new classification includes new treatment alternatives created over the last few years.
Methods:
Throughout the past 7 years, the authors developed a method to classify patients with symptomatic hemorrhoids. This study, besides presenting this classification proposal, also retrospectively analyzed 149 consecutive patients treated between March 2011 and November 2013 and aimed to evaluate the association between the management adopted with Goligher classification and our proposed BPRST classification.
Results:
Both classifications had a statistically significant association with the adopted management strategies. However, the BPRST classification tended to have fewer management discrepancies when each stage of disease was individually analyzed.
Conclusion:
Although there is much disagreement about how the classification of hemorrhoidal disease should be updated, it is accepted that some kind of revision is needed. The BPRST method showed a strong association with the management that should be adopted for each stage of the disease. Further studies are needed for its validation, but the current results are encouraging.
More Related Videos
07:13Comparison of Predictive Performance of Three Lymph Node Staging Systems in Colorectal Signet Ring Cell Carcinoma Based on Machine Learning Model
Published on: April 18, 2025
15:49Flexible Colonoscopy in Mice to Evaluate the Severity of Colitis and Colorectal Tumors Using a Validated Endoscopic Scoring System
Published on: October 16, 2013
Related Concept Videos
01:30Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation
Irritable Bowel Syndrome (IBS) is classified into subtypes based on the predominant bowel habits as determined by the Bristol Stool Form Scale (BSFS). The subtypes are:
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:25Assessment of the Rectum and Anus
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
01:17Chronic Bowel Disorders: Introduction
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...