Background and aim: Milligan-Morgan hemorrhoidectomy is still one of the most common types of surgery for hemorrhoids. Spasms in the internal anal sphincter are thought to be one of the reasons why people feel pain following hemorrhoidectomy. The purpose of this study was to assess the effectiveness of lateral internal sphincterotomy in alleviating post-hemorrhoidectomy pain.

Patients and methods: Between June 2021 and January 2025, 240 patients with third- and fourth-degree piles were included in this study. 130 patients (54.2%) were males, and 110 patients (45.8%) were females, with mean age 32 ± 8.2 years (mean ± SD). patients were randomized into two groups; each group includes 120 patients (Group A: subjected to hemorrhoidectomy plus lateral internal sphincterotomy and Group B subjected to hemorrhoidectomy only).

Results: (group A) did much better than (group B) as can be seen from the significant differences in the pain scores, greater need for analgesics, and early return to work (P< 0.05). Five patients from group (B) complained about urine retention and needed for catheterization, and fifteen patients developed anal strictures that were being treated with progressive anal dilatation.