![paina 93.1 paina 93.1](https://i.ytimg.com/vi/ooEOSEdnC5I/maxresdefault.jpg)
If the condition is symptomatic, recurrent or persisting prolapse is treated with repeat PPH when it is mobile and uniform, and with conventional haemorrhoidectomy when it is irreducible. To minimize post PPH recurrence, strict inclusion criteria and well-performed primary surgery, calibrated on the sufficient amount of prolapse resected, and occasionally combined with excision of residual haemorrhoids, should be demanded. Technique modifications and new devices in order to reduce post PPH recurrence need further validation. If symptomatic, recurrent or persisting prolapse is usually alleviated by repeat PPH in fixed and irreducible prolapse, conventional haemorrhoidectomy is preferred. Residual or recurrent prolapse after PPH is attributed to incorrect indication for surgery, insufficient resection, and technical errors mostly arising during the purse-string phase of the procedure. Post PPH recurrence rates range from 2% to 25.9% (7.7% on meta-analysis) and reoperation rates for recurrence are between 3.4% and 18%. Unsatisfactory outcomes concern post PPH symptoms and need for reintervention.Ī review of the updated literature to December 2014 was performed regarding post PPH recurrence. The procedure for prolapse and haemorrhoids (PPH) is widely accepted as safe and effective for haemorrhoidal disease (HD). The long-term outcomes of PPH in the treatment of third and fourth-degree hemorrhoids are similar to Milligan-Morgan hemorrhoidectomy. There were no significant differences in the overall complication rate(14.3% vs 12.7%), recurrence rates(12.1% vs 8.8%) and satisfactory degree (85.1 vs 88.2) between two groups as well. PPH significantly relieved constipation compared with MM(60.0% vs 32.1%, P 0.05). There were no significant differences between two groups(P >0.05). The data including symptoms relief, complication and recurrence were compared between two groups. All the patients suffered with third- or fourth-degree hemorrhoids. Ninety-one patients in PPH group and 120 patients in MM group, treated in our hospital from May 2001 to May 2005, were followed up. To compare the long-term results of procedure for prolapse and hemorrhoids(PPH) and Milligan-Morgan(MM) hemorrhoidectomy in the treatment of third- and fourth-degree hemorrhoids.