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Underlying functional bowel disorder may explain patient dissatisfaction after haemorrhoidal surgery
Author(s) -
Favreau C.,
Siproudhis L.,
Eleouet M.,
Bouguen G.,
Bretagne J.F.
Publication year - 2012
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/j.1463-1318.2011.02612.x
Subject(s) - medicine , constipation , logistic regression , defecation , irritable bowel syndrome , surgery , prospective cohort study , patient satisfaction
Aim The aim of this study was to assess patient dissatisfaction and functional symptoms following haemorrhoid surgery, aspects of which are seldom covered in other published series. Method A self‐administered questionnaire was mailed to 359 consecutive patients (prospective database; 198 men, 161 women; median follow up, 59 [1–120] months) who underwent either Milligan‐Morgan haemorrhoidectomy ( n = 205) or stapled haemorrhoidopexy ( n = 154). Results The response rate was 72%; 2.4% of patients had no opinion, 13.6% were dissatisfied, 33.0% were satisfied, and 51.0% were very satisfied with the treatment. Dissatisfied patients were more likely to be women and more likely to have a long history of constipation and irritable bowel syndrome. The duration of surgery and the rates of pre‐ and postoperative complications did not differ between groups. Residual bleeding (49% vs 32%), prolapse (67% vs 31%) and pain (91% vs 55%) occurred more frequently in the dissatisfied group compared with the satisfied group ( P < 0.001). Incontinence (4 [0–16] vs 1 [0–15]; P = 0.0003) and constipation (19 [1–34] vs 8 [0–31]; P < 0.0001) scores were significantly higher in the dissatisfied group compared with satisfied patients. Anal pain was the predominant symptom associated with dissatisfaction in a logistic regression model. Conclusion Persistent pain remains the major long‐term factor associated with dissatisfaction after surgery for haemorrhoids.