Ambulatory anorectal manometric findings in patients before and after haemorrhoidectom.

The physiological abnormalities in piles before and after surgery were studied by an ambulatory prolonged anorectal manometric technique. Eighteen consecutive patients (12 men, 6 women; mean age 43.6 [standard error of mean, 3.3] years) with 3 prolapsed irreducible piles were prospectively recruited. Haemorrhoidectomy was performed with excision of 3 piles. The anal and rectal pressures were monitored before and at a mean 7.8 (1.5) weeks after surgery when the wounds had healed, for a mean period of 361.3 (47.8) min. The maximum anal pressures dropped significantly from a mean 325 (15.5) mmHg before to 213 (24.9) mmHg after surgery (P < 0.05). Ultraslow wave activity was clearly identified in 11 of 18 patients (61%) before surgery, but not found on post operative studies. The maximum rectal pressures were also significantly reduced after surgery (196.8 [23.2] mmHg before, 75.5 [10.6] mmHg after; P < 0.05). These findings help to confirm that haemorrhoidectomy leads to changes in the anorectal physiological findings.