Evaluating Laser Haemorrhoidoplasty as a Short-Term Approach to Advanced Haemorrhoidal Disease.

Background Haemorrhoids are a benign anorectal condition that can significantly impact the quality of life of patients. Well-established treatments for advanced haemorrhoidal disease are not without complications. Laser haemorrhoidoplasty (LHP) is a less invasive non-excisional surgical technique that has fewer complications than conventional management. Methodology A retrospective study of all patients who received LHP for symptomatic Grade 3 and Grade 4 haemorrhoids from November 2017 to March 2022 in a district general hospital was conducted to assess short-term functional outcomes. Patients were asked to report the severity of pain on the Visual Analogue Scale and frequency of symptoms based on the Haemorrhoidal Severity Score (HSS developed by Nyström) two months before and after LHP. Participant consent and feedback were obtained either by a written questionnaire or a phone interview. Results A total of 57 patients were interviewed. The most common symptoms were bleeding (n = 54), prolapse needing reduction (n = 45), pain (n = 43), itching and discomfort (n = 28), and soiling (n = 24). There was a significant improvement in the severity of pain (p < 0.0001) postoperatively. Patients reported an improvement of their pre-existing symptoms, including pain (p < 0.00001), itching and discomfort (p = 0.0001), bleeding (p < 0.00001), soiling (p = 0.00007), and prolapse (p < 0.00001) based on HSS. Conclusions Evidence from this study suggests that LHP provides significant short-term improvement in the severity of symptoms for patients with symptomatic third- and fourth-degree haemorrhoids. While the results of this study are encouraging, larger prospective multicentre studies assessing long-term outcomes will be desirable for proper evaluation of LHP with respect to its efficacy and cost-effectiveness.