This chapter review discusses the anatomy, pathophysiology, diagnosis, and management of prolapsing hemorrhoids. Each method of surgery has its own advantages and disadvantages. Non-excision surgery is divided into two types-stapled hemorrhoidopexy and hemorrhoidal artery ligation and rectoanal repair. However, since it comes with pain complaints, non-excision surgery is now offered. The surgical gold standard for prolapsing hemorrhoids is excision surgery (hemorrhoidectomy) with or without suturing. Medical therapy is rarely used alone, it is used to improve the effect of surgical therapy. Nowadays, the management of prolapsing hemorrhoids varies. Prolapsing hemorrhoids should be differentiated from prolapsing rectal polyps, small rectal prolapse, anorectal tumors, hypertrophy of the anal papilla, and condylomas. Grade III and IV prolapsing hemorrhoids are distinguished from grade II by the fact that grade II prolapse only during defecation and returns simultaneously after defecation and usually does not cause complaint. Patients mostly come with a complaint of anal bleeding or prolapsing mass. Hemorrhoids are a common anorectal disease and are often found in clinical practice.
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