Lateral internal sphincterotomy in the treatment of fourth degree haemorrhoids.

Between January 1984 and May 1988, 25 patients with fourth degree haemorrhoids were treated in the acute phase by lateral internal sphincterotomy under narcosis. Pain relief was immediate. The median hospital stay was 3 days. The median follow-up period was 26 months. For 20 patients a single lateral internal sphincterotomy alone was adequate treatment. If further therapy was required, simple band ligation was enough. There was one recurrence, which was treated with a further lateral internal sphincterotomy. In the long term, 18 patients had no complaints and seven had only minor complaints. Twenty-three patients were very satisfied and two were moderately satisfied. Nobody was dissatisfied. Lateral internal sphincterotomy is an attractive alternative in the treatment of fourth degree haemorrhoids, its major benefits being simplicity, efficiency and low morbidity.