We read with interest the details of the prospective randomised trial comparing circular stapled anopexy with closed diathermy haemorrhoidectomy by Thaha and co-workers.1 The authors state that stapled anopexy offers a significantly less painful alternative to excisional haemorrhoidectomy and achieves a higher patient acceptability. Although the overall symptom control and safety are similar in the majority of the patients, the re-treatment rate for recurrent prolapse at 1 year is higher following the stapled procedure when compared with conventional haemorrhoidectomy.1

The authors emphasised the reduction of postoperative pain in the stapled haemorrhoidectomy patients. We believe, however, that pain is not an ideal measure with which to compare stapling techniques with classic haemorrhoidectomy because of intertechnique differences …