جستجوی مقالات مرتبط با کلیدواژه « هموروئید » در نشریات گروه « پزشکی »

Hemorrhoid disease is one of the most common anorectal diseases that affect millions of people around the world. Implementing a hemorrhoid management and prevention program using its data management system can be an effective step to improve the quality of care, control disease, and improve the society health. The present study aims to determine the minimum data set (MDS) for electronic health record of patients with hemorrhoid disease in Iran.

In this descriptive-analytical stud that was conducted in 2021, related papers and clinical records of patients with hemorrhoid disease in Iran were first studied. Then, the proposed MDS was validated using a researcher-made questionnaire based on a Likert scale with acceptable content validity and test-retest reliability (r=0.90), and by implementing the Delphi technique based on the opinions of 20 experts (internal medicine specialists and general practitioners in hospitals of Ferdous and Birjand cities and health information management specialists in Ferdous city). Sampling was not done due to the low number of participants. Finally, the findings were analyzed using descriptive statistics in SPSS software version 19.

A total of 43 data elements were finally selected for implementing the Delphi technique. Of these, two data elements were removed in the first round; therefore, 39 data elements as well as two data elements with a score of 50-75% and three suggested data elements entered the second round of Delphi. Of these, 42 were approved in the second round.

Determining the MDS for electronic health record of patients with hemorrhoid disease can be an effective step towards integrating the information of these patients in Iran and can improve their information management.

Spinal anesthesia is generally used for surgeries related to the lower abdomen, perineum, and lower limbs. The purpose of this study is to compare immediate and delayed supine positions on the hemodynamic changes of patients undergoing hemorrhoid and Fischer surgeries under spinal anesthesia.

The present study is a case-control study that was conducted on 60 patients who were candidates for hemorrhoid and fissure surgery in Motahari Hospital of Jahrom city by a specific surgeon. Patients were randomly assigned to one of two groups of 30 people in the immediate and delayed supine positions. After the spinal anesthesia, the patients in the delayed supine position group were kept in a sitting position for 3-5 minutes and then assumed the surgical position. In the immediate supine position group, the patients were placed in the supine position after receiving spinal anesthesia and were ready for surgery. Systolic blood pressure, diastolic blood pressure, respiration, arterial oxygen saturation, and pulse of the patient were measured and recorded before and immediately after the position and at 10, 5, 15, 30, 45, 60, and 90 minutes after the position. Data analysis was done using descriptive and inferential statistics tests at a significance level of P<0.05.

The study groups were similar in terms of age and body mass index variables. The mean trend of systolic and diastolic blood pressure in the immediate supine position and delayed supine position groups showed a significant difference from the time before spinal anesthesia to 90 minutes after the operation (P<0.001). The trend of mean MAP and heart rate in the immediate supine position and delayed supine position groups showed a significant difference from the time before spinal anesthesia to 90 minutes after the operation (P<0.001). The amount of ephedrine consumed in the delayed supine position group (10%) was significantly lower than in the immediate supine position group (50%) (P=0.003).

The present study has indicated that the use of a delayed supine position can significantly reduce the number of hemodynamic changes over time compared to the immediate supine position and minimize the amount of ephedrine used to compensate for pressure drop.

Pain and burning are the main complaints after hemorrhoidectomy. Traditional Iranian Medicine and medicinal plants have the potential to be used in many similar cases. The aim of this study was to determine the effect of Arnebia euchroma ointment on pain and burning in patients after hemorrhoidectomy.

A parallel clinical trial was conducted in patients candidate for hemorrhoidectomy in Mashhad Qaem Hospital, Iran. Eligible patients (n=115) were randomly assigned into an experimental group or a control group. The experimental group received 10% Arnebia euchroma ointment, twice a day for a week after the surgery and in control group, Eucerin ointment was used. Pain and burning were measured in recovery and at 4, 12, 24, and 48 hours and 4 and 7 days after the surgery using VAS scale.

There were no significant differences in sex, age, disease and surgery history, and level of education between the two groups (P<0.05). Compared to the control group, the experimental group was found to experience less pain in recovery and at 4, 12, 24 hours, and 7 days after the surgery (P<0.001). Burning was significantly lower in experimental group at 4 and 12 hours after the surgery compared to the control group (P<0.01). But in other times, burning was not significantly different between the two groups (P<0.20).

Arnebia euchroma ointment reduced pain and burning after hemorrhoidectomy and did not cause any complications.

Constipation is one of the most common digestive problems in pregnant women which is commonly associated with hemorrhoids. Patients' non-compliance with lifestyle modification recommendations leads to failure of treatment with this method. Although therapeutic properties of coconut oil on constipation are discussed, but its scientific documentation has not been reported; therefore, this study was performed with aim to determine the effect of coconut oil ointment on the symptoms of constipation in pregnant women with hemorrhoids.

This randomized clinical trial study was performed on 60 pregnant women who referred to Mashhad Comprehensive Health Service Centers in 2018-2019. Eligible individuals were divided into two groups. The control group received only lifestyle modification recommendations, while the intervention group in addition to these recommendations used an applicator of coconut oil ointment twice a day for two weeks. The improvement of constipation symptoms including need for straining during defecation, hard stools and defecation less than 2 to 3 times a week was assessed using the Constipation Questionnaire in Pregnancy. Data were analyzed using SPSS software (version 16) and Chi-square, Fisher exact and Cochran tests. P< 0.05 was considered statistically significant.

The frequency of need for straining during defecation on the fourteenth day after the intervention in pregnant women in the coconut oil ointment group was significantly lower than the control group (p <0.05). In the intragroup comparison, it was found that in the group of coconut oil ointment, the difference in the need for straining during defecation and hard stools according to the day of measurement was significantly different (P <0.001), while in the control group, the difference in the need for straining during defecation and hard stools according to the day of measurement was not significant (p <0.05). In the intragroup comparison, defecation less than 2 to 3 times a week, although clinically was associated with a decrease in the coconut oil ointment group, but this decrease was not statistically significant (p=0.050).

Coconut oil ointment is effective in improving the symptoms of constipation in pregnant women with hemorrhoids, so its use is recommended in these people.

Hemorrhoid is one of the most common problems in pregnancy, especially in the second and third trimesters. In the absence of timely treatment and proper follow-up, the problem leads to a chronic disease that can impose harmful effects on the individual, the family and the society. Considering the high prevalence of this problem among pregnant women and failure to review the new advocacy, especially pharmacological and aggressive methods over the past 12 years, this study was performed with to review a variety of non-pharmacological and pharmacological treatments of hemorrhoids in pregnancy and their effectiveness.

To achieve the aim of the study, databases of PubMed, Scopus, ProQuest, Google Scholar, Science Direct, SID and Magiran were searched using English keywords of Hemorrhoid, Haemorrhoid, pregnancy, Pregnant, Medical Treatment, Conservative, Life style, Diet, Nutrition, Surgery, Hemorrhoidectomy and their Persian keywords were searched individually and in combination, from the timeframe covered until October 2019.

There are several methods to treat hemorrhoids during pregnancy, but many of these methods are based on the results of clinical trials on the general population of patients with this condition, so, due to the lack of sufficient and powerful clinical studies on the application of some methods and the prohibition or caution of using some other methods during pregnancy, deciding about the choice of treatment depends on the condition of each patient and considering the criteria such as: gestational age, the severity and degree of sustainability of symptoms as well observing the hierarchy of treatment from conservative and non-invasive approach toward aggressive methods.

There are various methods for the treatment of hemorrhoids, but sufficient and robust studies to confirm the efficacy and safety of these methods to the specific population of pregnant women are limited.

Hemorrhoids is one of the most common problems during pregnancy. Lifestyle modification recommendations are associated with patients' noncompliance. The potential therapeutic properties of coconut oil on hemorrhoids have been suggested, but its scientific evidence has not been reported, therefore this study was performed with aim to determine the effect of coconut oil ointment on hemorrhoids symptoms in pregnant women.

This randomized clinical trial was performed on 60 pregnant women referred to comprehensive health services centers in Mashhad in 2018-2019. The subjects were randomly divided into intervention and control groups. In the intervention group, one applicator of coconut oil ointment was applied twice a day for two weeks; they also received lifestyle modification recommendations. The control group only received lifestyle modification recommendations based on national guidelines. The improvement of hemorrhoids symptoms was measured on the first, seventh and fourteenth days using Visual Analog Scale (pain, prolapse, itching and overall score of hemorrhoid symptom). Data were analyzed using SPSS software (version 16) and Mann-Whitney, Independent T and Friedman tests. P<0.05 was considered statistically significant.

The mean score of pain, prolapse, itching and overall score of hemorrhoid symptoms in coconut oil ointment group significantly decreased compared to the control group (p<0.05). In the intra-group evaluation, in the coconut oil ointment group, the pain score measured by day was significantly different (p<0.001) but in control group this difference was not significant (p=0.050).

Coconut oil ointment is effective in improving the hemorrhoids symptoms, therefore it is recommended for pregnant women with hemorrhoids grade 1 and 2.

Todays one of the most common anorectal problems is hemorrhoid. Minor symptom of disease can be treated by medical treatment but at high grade disease we should consider surgery. Although conventional surgery is standard operation for hemorrhoid, it is associated with some complication. Many techniques were designed to overcome these problems. One of these procedures stapled hemorrhoidopexy that this study was done to compare it with conventional hemorrhoidectomy. Subjects and This is a clinical trial study was conducted on 40 patients with hemorrhoids in Ahvaz Razi Hospital. Patients were randomly divided into two groups. Group A (n=20) was treated with stapled hemorrhoidopexy and Group B (n=20) was treated with conventional hemoroidectomy method. Sphincter tone, resting and pressing before and after surgery was measured and compared between two groups. . Data analysis showed that there was no significant differences in tone sphincter resting and pressing before and after surgery in stapled hemorrhoidopexy group and conventional hemoroidectomy group (P-value=0.32). Also, there was no significant difference between the mean scores of pain in groups (P-value=0.32). However, the loss of blood, the need for analgesic drugs and return to work in stapled hemorrhoidopexy group was significantly lower than that of conventional surgery group (P-value<0.001). Findings of study showed that stapled hemorrhoidopexy is an alternative and effective treatment that can be used in adult age groups to reduce pain, side effects, duration of hospitalization and time to return to work.

The hemorrhoid is referred to dilated parts of the anal canal veins, which help to control fecal excretion and is one of the most common digestive diseases. Since postpartum problems such as hemorrhoid have significant effect on physical health and psychological well-being, lactation, baby care, and communication with family and society and affect the health of mothers and children, and considering the importance of postpartum quality of life, and due to the limited studies in this field, this study was performed with aim to determine the association between the severity of hemorrhoid symptoms and quality of life in women with grade I and II internal hemorrhoids during postpartum period. This cross-sectional study was performed in 2017 on 131 women in postpartum period in Tehran. Clinical Therapeutic Clinical Evaluation Questionnaire and World Health Organization Quality of Life were used to collect data on hemorrhoid symptoms and quality of life. Data were analyzed using SPSS software (version 21) and Pearson and Spearman tests. P<0.05 was considered statistically significant. The highest and lowest mean score of quality of life was obtained in the sub-domains of environmental health and physical health, respectively. The lowest and the highest mean score for hemorrhoid symptoms was related to the symptoms of itching and the negative effect of hemorrhoids on the health of women. There was a significant negative correlation between the overall quality of life score with all the symptoms of hemorrhoids except pruritus (r = -0.2 to r = -0.28, p <0.05). There was also significant negative correlation between the symptoms of swelling in the anus and dimensions of social health (r = 0.24, p = 0.006) and environmental health (r = 0.20, p = 0.02) with the quality of life. There was also a negative and significant correlation between the symptom of discomfort in the anus and the subtype of physical health of the quality of life (p = 0.04, p = 0.18). None of the socio-demographic characteristics had a significant relationship with quality of life (p >0.05). The symptoms of hemorrhoids have negative effect on the quality of life in postpartum period.

There are various methods to treat hemorrhoids. It is very important to examine which hemorrhoidectomy has fewer complications and also faster recovery and return of the patient to normal life. The aim of this study was to compare the clinical outcomes of two methods, including Milligan-Morgan surgery and the hemorrhoid system in patients with hemorrhoids.
Methods and Materials: In this cross-sectional study, sixteen patients were randomly chosen from all patients with hemorrhoids referring to the clinics of Bahonar and Afzalipour hospitals who needed surgical diagnosis of the surgical specialist. Patients were classified into two groups regardless of gender. Group A was operated by open or Milligan- Morgan and group B was performed by the hemorapy method. After surgery, patients’ information was recorded in a checklist and analyzed by SPSS (version 21) software. 37 patients (64%) were male and 23 (36%) were female. 19 patients (32%) had hemorrhoid Fourth degree, and 41 patients (68%) had hemorrhoid Third-degree. The mean pain of patients after 8 weeks of surgery between the two groups was 1.12±0.57 in the Milligan-Morgan group and 0.55±0.47 in the hemorapy group, respectively. This difference was statistically significant. (pvalue=0.042). However, there were no bleeding events, urinary retention, and incontinence, and in 2 patients treated with the Milligan-Morgan method, it was observed that there was no anal stenosis in patients with hemorapy.
Discussion and The results showed that the postoperative pain was less in the hemorapy method than in the Milligan-Morgan method. Furtheremore, complications such as bleeding, urinary retention and gas incontinency and anal stenosis were much less than the MilliganMorgan method. This method is used for hemorrhoidectomy.

Most common causes of lower gastrointestinal bleeding (LGIB) in young patients are benign perianal lesions, but serious colorectal disease may be underlying etiology in this group. The aim of this study was identification of LGIB etiologies in the patients under 40 years old.
Materials: In this retrospective descriptive study, which has been done during 2012-2013, 333 young patients (less than 40 years old) with lower GIB referred to Endoscopy Ward of Yazd Shahid Sadoughi Hospital assessed by colonoscopy with or without histopathology.
Resultus: In this study, 57% of patients were males. Majority of them were between 30-40 years old. The most common presentation was hematochezia (49%) and the most common cause was internal hemorrhoid (17%). Other causes included: inflammatory bowel disease (15%), polyp (9%), infectious colitis (8%), anal fissure (6%), colon cancer (4%), solitary rectal ulcer (4%), vascular lesion (2%), aphtus lesion (1.1%), diverticulosis (0.6%) ,anal tuberculosis (0.3%) and normal colon (33%).
Considerable number of our cases had inflammatory bowel disease and malignancy. Seven patients had serious disease and simple anal disease simultaneously.
Significant portion of LGIB in the patients less than 40 years old are due to serious colorectal disease. So, careful approach and appropriate timing for colonoscopy is recommended.

Introduction & Hemorrhoid surgery is one of the most common diseases in the anorectal region that can show by pain and bleeding and a mass exit from the anus and one of the main reasons that make the patient avoid surgery is afraid of the pain. Control the postoperative pain especially in the first 24 hours in addition to increasing patient satisfaction will also lead to a decrease urinary retention and constipation and reduce pain from surgery will be more patient welcoming. Study presented to examine the effect of Pudendal nerve block on pain relief after surgery in both groups blocked with general anesthesia and general anesthesia alone.
In a successive clinical trial of patients undergoing perianal surgery 42 patients with a mean age 35/40 years who refer by happened to Bu Ali, Resalat and Milad Hospitals in Tehran were randomly divided into two groups nerve block with general anesthesia (n = 21) and general anesthesia alone (n = 21). in the first group was performed General anesthesia and nerve block and in the second group was performed under general anesthesia alone then the test scores of 6 and 24 hours after surgery was calculated with using a pain scale chart in each group. Values obtained were compared with Square- Chi test and the results were evaluated.
The mean pain scores at 6 and 24 hours after surgery under blocked and general anesthesia group were respectively 2.4, 2.7 and in the general anesthesia group alone were respectively 3.23 and 3.05. P value equal to 0.004 and 0.048 in the two groups above hours and for comparison of the two groups was 0.05.
In this study, the pudendal nerve blocks cause significant pain relief after the first hours after the hemorrhoidectomy operation.

Constipation and hemorrhoids are common problems during the postpartum period. Therefore, effective measures should be taken to diminish the deleterious effects of these complications on maternal health. In this study, we aimed to determine the efficacy of postpartum home care on the rate of constipation and hemorrhoids. This clinical trial was conducted in two phases on 276 women, who gave birth at hospitals, affiliated to Shahid Beheshti University of Tehran, Iran in 2013. The subjects were divided into intervention (n=92) and control (n=184) groups. First, a model of care was designed by comparative analysis and collection of data on home care guidelines for mothers and newborns, applied in different countries. In the second stage, women received home care services, based on the proposed model (on days 3-5 and 13-15 postpartum). On the other hand, subjects in the control group did not receive any services. The rates of constipation and hemorrhoids were recorded and compared via history taking and clinical examinations by midwives on day 60 following delivery. (IRCT:2013060313565N1) The mean age of the participants was 27±5 years. Based on the evaluation of outcomes on day 60 following delivery, constipation was reported in 13% of cases in the intervention group and 26.1% of subjects in the control group. Moreover, hemorrhoids were reported in 12% and 9.8% of women in the intervention and control groups, respectively; however, there was no significant difference between the two groups in terms of these complications. Based on the results of this study, postpartum home care, complemented with physical exercise, a healthy diet, and use of laxatives in unresponsive cases to supportive treatment, could reduce constipation, whereas hemorrhoids remained unaffected.

Introduction & Hemorrhoids are a common cause of perianal complaints. The aim of this study was to compare Ferguson hemorrhoidectomy and hemorrhoidectomy with ligasure. Sixty eight patients with symptomatic grade II، grade III and IV hemorrhoids were randomly allocated to undergo either Ferguson hemorrhoidectomy (34patients) or hemorrhoidectomy with Ligasure (34patients). The patients were compared for the difference between techniques in operative time، postoperative pain incontinence، urinary retention، bleeding، local infection، anal stenosis، and time of hospitalization. The patients were matched with respect to age، gender، and chief complaints. At discharge time، there was no statistically significant differences in the frequency of postoperative complications like pain and urinary incontinence between the two groups except for postoperative pain which was more frequent in the group A. Operative time in group B was shorter than group A، and this difference was significant statistically. There were no significant differences between other complications at discharge time، one week and one month after the operation. We recommend hemorrhoidectomy with ligasure for patients with symptomatic grade II، Grade III and IV hemorrhoids in comparison with ferguson hemorrhoidectomy.

Introduction & Surgical therapy is still useful and preferred for patients with large third-degree or fourth-degree hemorrhoids. One of the novel methods in the surgical treatment of hemorrhoid is laser therapy. The aim of this study is to evaluate the outcome of closed hemorrhoidectomy versus laser therapy. In this study, 56 patients with internal hemorrhoids of grade III, who were admitted to the hospital, were divided randomly into two groups, each one containing 28 patients. The first group were treated by using laser hemorrhoidectomy and the other group underwent the Ferguson closed hemorrhoidectomy. Visual pain score and complications such as bleeding, urine retention, anal stricture, gas and fecal incontinence and infection were compared in the two groups. The data in questionnaire and forms were analyzed with SPSS software and descriptive statistics and if needed statistical tests of T-test and chi- square test was done, and if needed accurate Fisher test was used. A P-value of less than 0.05 was considered as statistical significance level. There was no significant difference between age and sex in the two groups. Visual pain score in laser hemorrhoidectomy in the first 24 hours (1.42 ± 1.57) and during the first week (0.49 ± 0.39) was significantly less than the case of closed hemorrhoidectomy group (respectively 1.91 ± 2.57 and 0.58 ± 0.75). Except in the cases of bleeding, which was considered to be significantly lower in laser therapy than control group, the difference between the two groups was not significant as far as other complications is concerned. The two groups did not differ in duration of surgery. However, the cost of laser hemorrhoidectomy group was significantly higher (P< 0.001). Despite higher costs, laser treated hemorrhoidectomy patients experienced less pain than the standard hemorrhoidectomy patients. So, we suggested laser therapy as the preferable method in treating hemorrhids.

Background and

Todays one of the most common anorectal problems is hemorrhoid. Minor symptom of disease can be treated by medical treatment but at high grade disease we should consider surgery. Although conventional surgery is standard operation for hemorrhoid، it is associated with some complication. Many technique were designed to overcome these problems. One of these procedures is Ligasure hemorrhoidectomy that this study was done to compare it with conventional hemorrhoidectomy.

This was a randomized cilinical trial study of 60 patients with third-degree or four-degree hemorrhoid that was divided into two groups randomly. Operative time، bleeding، postoperative pain، rate of wound healing were recorded.

we randomized 60 patients، 30 to Ligasure and 30 to conventional. There were no difference in patients demographic datas. Operative time، bleeding، pain at second postoperative day in Ligasure group was less than the conventional. There was no difference in rate of healing، pain at first day postoperation and complications.

Ligasure hemorrhoidectomy is a safe and feasible procedure and in comparison with conventional hemorrhoidectomy cause more pain control and satisfaction.

Hemorrhoidectomy is the basis of treatment for grades three and four hemorrhoid. One of the major post hemorrhoidectomy problems is pain that is usually due to the spasm of the internal sphincter. There are different methods for the management of postoperative hemorrhoidectomy pain. The aim of this study was to investigate the effect of sphincterotomy on post hemorrhoidectomy pain. This interventional clinical trial was conducted on 60 patients with 3rd and 4th grade hemorrhoid who had randomly been divided into hemorrhoidectomy and hemorrhoidectomy combined with sphincterotomy groups. The degree of pain was measured on visual analogue scale (VAS) and analyzed through Mann-Whitney, Friedman, and Chi square tests via SPSS version 14. In terms of reduction in pain with sphincterotomy, there was a significant relationship between the two groups on the first, second, and fifth postoperative days (P=0.001). On the third and sixth postoperative days, a significant relationship was observed between the two groups (P=0.001). Days four and seven also indicated a significant relationship between the two groups (P=0.002). However, there were not any significant relationships between the two groups in terms of urinary and fecal incontinence and gas retention (P>0.05). A significant relationship existed between the two groups in terms of reduction in the need for sedation (P=0.006). Lateral internal sphincterotomy combined with hemorrhoidectomy can reduce the patients’ post hemorrhoidectomy pain and can reduce the use of analgesics, but it does not have any significant influences on the incidence of urinary retention and bleeding after the first defecation and does not increase the risk of fecal and gas incontinence in comparison with the hemorrhoidectomy group.

Anal fistula is the most common cause of severeanal pain during rectal surgery. Patients experience pain and discomfort duringthe immediate post-operative period and some specialties e.g., physiotherapycould be taken into account for mitigating pain and improving the scar healing.Although no researches have performed concerning the post rectal surgeryphysiotherapy, it leads to surgeons uncaring to this apparently important point.Therefore, the current study aimed to prepare a new physiotherapy protocol afterrectal surgery and to investigate its effectiveness in one patient. This study carried out on a 45 year-old male. He wassuffering from pain and bleeding in the rectal area and on medical examinationand colonoscopy, he was diagnosed with external hemorrhoid and anal fistula.After hemorroidectomy and fistulectomy, physiotherapy protocol was performedin five phases. The results showed that the pain medication needed just for 4 days and the patient returned to work within 3 days. In addition, the intensity of pain,difficulty in bowel movement, difficulty in mobility, and stress from bowel movement (measured by VAS) removed within 5th days. This result in comparison with previous studies showed the faster improvement of the pain and scar healing and complete recovery took about 4 weeks. The beneficial effects of physiotherapy protocol were demonstrated, especially in aged patients with background diseases.

Introduction & Submucosal hemorrhoidectomy is one the of accepted techniques of surgery but it has never been a popular operation. The advantage of this surgical method is that it minimizes the injury to anoderm and mucosa of anus. The aim of this study was to compare between submucosal hemorrhoidectomy and Ferguson hemorrhoidectomy. In a clinical double-blind controlled trial, 60 patients with grade 3 and 4 hemorrhoids were randomly divided into two groups: 1) submucosal hemorrhoidectomy (30 patients) and 2) Ferguson hemorrhoidectomy (30 patients). These patients were evaluated for early and delayed post operative complications such as pain, bleeding, urinary retention, constipation, fecal impaction, incontinency, surgical site infection, fissure, skin tag, mucosal ectropion, anal stenosis and recurrence. They were regularly followed up at 24 hours, 1 week, 3 months and 6 months after their operation. There were no statistically significant differences between two these groups in terms of age, gender and grade of hemorrhoid(s). Patients treated with submucosal hemorrhoidectomy has significantly less pain within 24 hours after the surgery (P=0.026), but there was no statistically differences between two groups in anal stenosis and other complications. Submucosal hemorrhoidectomy is an effective method in reducing post operative pain within the 24 hours after the surgery and was no case of complicated anal stenosis after 6 months follow up. Other complications in the submucosal technique were similar to those of Ferguson. Submucosal hemorrhoidectomy is comparable with Ferguson technique as a suitable procedure for high grade prolapsed hemorrhoids.

Introduction & Submucosal hemorrhoidectomy is one the of accepted techniques of surgery but it has never been a popular operation. The advantage of this surgical method is that it minimizes the injury to anoderm and mucosa of anus. The aim of this study was to compare between submucosal hemorrhoidectomy and Ferguson hemorrhoidectomy. In a clinical double-blind controlled trial, 60 patients with grade 3 and 4 hemorrhoids were randomly divided into two groups: 1) submucosal hemorrhoidectomy (30 patients) and 2) Ferguson hemorrhoidectomy (30 patients). These patients were evaluated for early and delayed post operative complications such as pain, bleeding, urinary retention, constipation, fecal impaction, incontinency, surgical site infection, fissure, skin tag, mucosal ectropion, anal stenosis and recurrence. They were regularly followed up at 24 hours, 1 week, 3 months and 6 months after their operation. There were no statistically significant differences between two these groups in terms of age, gender and grade of hemorrhoid(s). Patients treated with submucosal hemorrhoidectomy has significantly less pain within 24 hours after the surgery (P=0.026), but there was no statistically differences between two groups in anal stenosis and other complications. Submucosal hemorrhoidectomy is an effective method in reducing post operative pain within the 24 hours after the surgery and was no case of complicated anal stenosis after 6 months follow up. Other complications in the submucosal technique were similar to those of Ferguson. Submucosal hemorrhoidectomy is comparable with Ferguson technique as a suitable procedure for high grade prolapsed hemorrhoids.