Polidocanol foam sclerotherapy for patients with Goligher grade IV hemorrhoidal disease unwilling to undergo surgery: preliminary outcomes from a retrospective study with 6-month follow-up.
4 affiliations
- 1Department of General Surgery, Azienda Sanitaria Locale ASL Lecce, Casarano, Italy.
- 2Colorectal Surgery Unit, IRCCS San Raffaele Scientific Institute, Faculty of Medicine and Surgery, Vita-Salute University, Via Olgettina 60, 20132, Milan, Italy.
- 3Department of Experimental Medicine, University of Salento, Lecce, Italy. [email protected].
- 4Department of Human Physiology, Laboratory of Biometry, University of Tor Vergata, Rome, Italy.
Abstract
Background
Polidocanol foam (PF) sclerotherapy has shown promising results in low- and intermediate-grade hemorrhoidal disease (HD), but evidence in advanced stages remains limited. This study aimed to evaluate patient-reported outcomes following PF sclerotherapy in patients with Goligher grade IV HD who declined surgical treatment.Methods
This retrospective analysis included patients with Goligher grade IV HD that declined hemorrhoidectomy after appropriate counseling and underwent 3% PF sclerotherapy between June and October 2025. Outcomes were assessed using symptom-focused subsets derived from the PROM-HISS and HDSS instruments at baseline, 7 days, 30 days, and 6 months. Primary outcome was the change in scores over time. Secondary outcomes included need for additional treatment, complications, and subsequent surgery.Results
Fifteen patients were included (mean age 58 ± 11 years; 53.3% male). At 6 months, 66.7% of patients requested no further hemorrhoidal treatment. Significant improvements were observed in both scores across all follow-up timepoints (p < 0.05). Pain, bleeding, and prolapse showed the most consistent reductions. One patient (6.7%) required hemorrhoidectomy within 30 days, four patients (26.7%) a second sclerotherapy session. No major complications were observed.Conclusions
In selected patients with Goligher grade IV HD who are unwilling or unfit to undergo surgery, PF sclerotherapy may be associated with short-term symptom improvement and may represent a symptom-oriented minimally invasive option for selected patients unwilling or unfit to undergo surgery.
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BibTeX
@article{gravante2026polidocanol,
title = {{Polidocanol foam sclerotherapy for patients with Goligher grade IV hemorrhoidal disease unwilling to undergo surgery: preliminary outcomes from a retrospective study with 6-month follow-up.}},
author = {Gianpiero Gravante and Veronica De Simone and Arcangelo Picciariello and Roberto Sorge and Pierpaolo Sileri and Gaetano Gallo},
journal = {International journal of colorectal disease},
year = {2026},
month = jul,
doi = {10.1007/s00384-026-05208-5},
url = {https://europepmc.org/article/MED/42909517},
note = {CC BY},
}
RIS
TY - JOUR
TI - Polidocanol foam sclerotherapy for patients with Goligher grade IV hemorrhoidal disease unwilling to undergo surgery: preliminary outcomes from a retrospective study with 6-month follow-up.
AU - Gianpiero Gravante
AU - Veronica De Simone
AU - Arcangelo Picciariello
AU - Roberto Sorge
AU - Pierpaolo Sileri
AU - Gaetano Gallo
PY - 2026
DA - 2026/07/28
JO - International journal of colorectal disease
DO - 10.1007/s00384-026-05208-5
UR - https://europepmc.org/article/MED/42909517
AB - Background Polidocanol foam (PF) sclerotherapy has shown promising results in low- and intermediate-grade hemorrhoidal disease (HD), but evidence in advanced stages remains limited. This study aimed to evaluate patient-reported outcomes following PF sclerotherapy in patients with Goligher grade IV HD who declined surgical treatment.Methods This retrospective analysis included patients with Goligher grade IV HD that declined hemorrhoidectomy after appropriate counseling and underwent 3% PF sclerotherapy between June and October 2025. Outcomes were assessed using symptom-focused subsets derived from the PROM-HISS and HDSS instruments at baseline, 7 days, 30 days, and 6 months. Primary outcome was the change in scores over time. Secondary outcomes included need for additional treatment, complications, and subsequent surgery.Results Fifteen patients were included (mean age 58 ± 11 years; 53.3% male). At 6 months, 66.7% of patients requested no further hemorrhoidal treatment. Significant improvements were observed in both scores across all follow-up timepoints (p < 0.05). Pain, bleeding, and prolapse showed the most consistent reductions. One patient (6.7%) required hemorrhoidectomy within 30 days, four patients (26.7%) a second sclerotherapy session. No major complications were observed.Conclusions In selected patients with Goligher grade IV HD who are unwilling or unfit to undergo surgery, PF sclerotherapy may be associated with short-term symptom improvement and may represent a symptom-oriented minimally invasive option for selected patients unwilling or unfit to undergo surgery.
SN - 0179-1958
SN - 1432-1262
ER -