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Could anybody help me? i got hemorrhoid for over than ten years but never bleeding or cause pain, only sometime its feel discomfort.
Now the Hemorrhoid size is quite big. I've been from dokter and done twice rubber band but it seems not to good. So which treatment is right for me?

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From my experience, don't go for the new fancied
stapledmethod. It can have complications like bleeding,
fecal urgency, anal stenosis and strictures. The only
real advantage of the PPH method is lesser pain.

I even had two episodes of fecal impaction one or two
months after the surgery, just when I thought I had fully
recovered.

Recurrence rate is high too. I had it done three years ago
and an external hemorrhoid has now recurred.

Ask your surgeon to use the harmonic scalpel or laser,
which has lesser pain and far less bleeding than standard
diathermy or cautery. The laser, one surgeon told me, is
more suitable for first to second degree hemorrhoids.

The newer Ligasure device is also good, and has lesser
pain than even the harmonic scalpel, but there may be
a risk of damage to the anal sphincter.

This surgeon I saw recently says he will excise this recurred
external hemorrhoid with the harmonic scalpel. He says it
is too round to be banded, and the pain will be excruciating,
although I said I could take the pain (banded twice before)
and I insisted on it to be banded.

Banding, as you noted, don't work very well though, and
at best last about 5 years. It works well to control bleeding.
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Recurrence may also be due to unhealthy lifestyles. Switch to a high-fiber diet, get some exercise, and do not sit for prolonged periods. Avoid things like caffeine. You should starting changing your habits right now as it will take some time to get used to it, but it helpes to prevent recurrence, and extends the effectiveness of your surgeries.
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