This complication was also associated with additional procedure (p= 0.006), presence of anal epithelium in the resected specimen (p = 0.04), hematoma of specimen (p = 0.03) and perianal hematoma (p = 0.02). Conclusions: Severe postoperative pain after stapled hemorrhoidectomy seems to be avoidable with correct indications and carefully performance by experienced colorectal surgeons.