Long-term results of haemorrhoidectomy

Objective: To assess the long-term functional results of Milligan-Morgan haemorrhoidectomy. Design: Retrospective multicentre study. Setting: One university hospital, one county hospital, and two community hospitals, Sweden. Subjects: 507 of 556 patients who were operated on for haemorrhoids by the Milligan-Morgan technique between January 1987 and December 1995. Intervention: A questionnaire was sent to all 507 patients, the questions in which focused on functional results and satisfaction. Main outcome measures: Patients' satisfaction and symptoms of anal incontinence after haemorrhoidectomy. Results: 418 of the 507 responded (82%). Altogether 279 patients (67%) reported a successful result, while 139 patients (33%) reported impaired anal continence. 40 of the 139 patients (29%) claimed that the incontinence was a direct result of the haemorrhoidectomy. Female sex (p=0.005) and an operation for hygienic problems (p=0.02) were associated with a higher risk of incontinence. Conclusion: Impaired anal continence is common after Milligan-Morgan haemorrhoidectomy and a large proportion of affected patients relate their problems to the operation.