Having problems with your hemorrhoids that is getting unbearable and yet the need
for ease and comfort being shadowed with fear of undergoing surgery, the conventional
Fear not…science had developed ways that widen the treatment options for anyone suffering.
In upper grade of hemorrhoids (Grade 2 to 4), the other option to the conventional
treatment is Procedure for Prolapse and Hemorrhoids (PPH).
What Is PPH?
PPH is also know as stapled hemorrhoidectomy, stapled hemorrhoidopexy, and circumferential
mucosectomy, which is a minimally invasive procedure that reduces the prolapse of
A unique stapling technique is used to pull the swelling blood vessels back into
their normal position. Very tiny titanium staples - only a few millimeters long used
The PPH procedure involves giving the patients who will undergo the surgery with
an enema and are recommended to take a gentle laxative twice a day, for two days
before the surgery.
The actual surgery procedures involved with the insertion of the anal dilator / obdurator;
preparation of the purse-string suture and initial placement of the circular stapler
that is inserted in the anal canal.
This technique that was developed in the early 90's can reduce the prolapse of hemorrhoidal
tissue by removing a band of the prolapsed anal mucosa membrane with the placement/insertion
of a circular stapling device, which then allows the excess prolapsed tissue to be
removed while the remaining hemorrhoidal tissue is stapled, thus, restoring back
the original anatomical position of the hemorrhoidal tissue.
PPH lasts generally 15-45 minutes. Patients also could choose to have a general anesthetic
during PPH, although local or regional anesthetics are also an option.
Patients who had undergone with PPH can go home a few hours after waking up.
Since the body heals in different speeds and reactions, post-operative pain from
PPH can be experienced but minimal than the conventional way. Patients who undergone
the PPH experience are often able to resume normal activities within a few days of
leaving the hospital.
As with any surgical procedure, there are risks that accompany PPH. People who are
eligible for the procedure are advised to discuss these risks with their doctor.
• Although rare, like the conventional hemorrhoidectomy, there are also risks with
PPH. Some of which if when using the device, muscle tissues that are drawn goes beyond
the affected area and damage to the rectal wall can be an outcome.
• During the procedure, the possibility of the sphincter’s internal muscle to stretch
could result to some dysfunction. Like with other surgical procedures with hemorrhoids,
pelvic sepsis may occur after stapled hemorrhoidectomy procedure.
•A great possibility for PPH not to succeed is when patients suffer or has a large
confluent hemorrhoid. The confluence block access to the anal canal and the large
mass of tissue might be too large to be contained in the stapling device’s housing.
• There is also the possibility of unrelenting pain and the feeling of the need to
remove bowel after stapled hemorrhoidectomy. Cases such as these has been reported
in a few cases.
In most cases reported, people who choose to undergo PPH have said to be satisfied
with results: having less postoperative pain, more satisfaction, and shorter hospital
stay than those who have the conventional hemorrhoidectomy way.
Though, satisfaction can be attained, possible risks should be prevented in anyway.
Cooperation and consultation with the experts are still essential to any surgical
treatments. Should you have any queries relating to your particular condition it
is highly recommended that you consult your Doctor.