Hemorrhoid Suture Mucopexy Combined With Laser Hemorrhoidoplasty
Prospective Evaluation of Hemorrhoid Suture Mucopexy (SM) Combined With Laser Hemorrhoidoplasty (LHP) for Symptomatic Hemorrhoidal Disease: A Cohort Study
National and Kapodistrian University of Athens
100 participants
Jan 1, 2026
OBSERVATIONAL
Conditions
Summary
This prospective cohort study evaluates whether combining "suture mucopexy" (a simple stitch-based lift of prolapsed tissue) with Laser Hemorrhoidoplasty (LHP) can effectively relieve pain, bleeding and prolapse in adults with moderate-to-severe hemorrhoids (Grades II-IV). Participants will undergo the combined, non-Doppler-guided procedure and be followed for one year. The primary question is how long patients need post-operative pain medication and if they first experience complete symptom relief; secondary questions examine quality-of-life, safety (bleeding, urinary retention, stenosis) and the rate of hemorrhoid recurrence/re-operation.
Eligibility
Inclusion Criteria3
- Adults (\>18 years).
- Symptomatic Hemorrhoidal Disease (Goligher Grades II, III, IV).
- Patients with or without recurrent disease after prior procedures (e.g., RBL, infrared coagulation, Milligan-Morgan, etc).
Exclusion Criteria4
- Acutely thrombosed hemorrhoids.
- Concomitant anal fistula or abscess requiring separate surgical management.
- IBD (Crohn's/Ulcerative Colitis) with active rectal involvement.
- Previous Stapled Haemorrhoidopexy (SH/Longo).
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Interventions
The procedure combines laser ablation (LHP) with suture mucopexy (SM) performed without Doppler guidance. Suture Mucopexy (SM): Using a slotted proctoscope, continuous suture mucopexy (plication) is performed at standardized anatomical positions (typically 4, 7, 11 o'clock) to lift the prolapse and ligate feeding vessels. Sutures are placed approximately 2-4 cm proximal to the dentate line. Laser Hemorrhoidoplasty (LHP): A 1470nm diode laser fiber is inserted into the hemorrhoidal cushion. Energy is delivered (approx. 250-350 J per pile) to induce shrinkage and fibrosis.
Locations(1)
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NCT07404774