This is the question people ask at the end of a successful course of treatment, and it deserves a better answer than a shrug. The short version is that a procedure and a cause are two different things.
Every single treatment on this site addresses tissue that already exists. A band cuts off its supply, infrared coagulates it, surgery removes it altogether. Not one of them changes the pressure, the straining or the stool consistency that produced that tissue in the first place.
So the honest framing is that treatment and prevention are two separate jobs, and clinics have a fairly obvious commercial incentive to stay vague about that distinction. A procedure presented as the end of it is overselling, whichever procedure happens to be the one being presented.
Which means the thing deciding whether this comes back sits almost entirely outside the clinic. Conservative care is the whole of the prevention side, toilet habits is the lever most people have never actually changed, and fibre and diet is the other half of it.
Recurrence in Montreal
What actually helps
Keeping it away after Montreal treatment
Stool consistency
The single biggest lever, and it is about fibre and fluid together rather than either one on its own.
Time on the toilet
Less of it. This is the change most people have not made, and the one that needs no shopping.
Straining
Going when the urge arrives rather than waiting, which is what turns a short visit into a long one.
Watching for the signs
If symptoms return, having them looked at rather than reaching for a cream for another six months.
By procedure
Does recurrence differ by procedure?
Somewhat, and the one thing published clearly here is that complication and recurrence rates after sclerotherapy can be higher, which is noted in a review rather than being any clinic’s opinion about it. That is a reason it gets chosen deliberately rather than reached for by default.
Beyond that one specific point, we are not going to rank the procedures by durability, because the published figures for them disagree enough that any ranking would be a choice rather than a finding. What the evidence says goes through exactly how much they disagree.
What is a safer generalisation is simply that removing the tissue leaves nothing in that position to come down again at all, which is part of why surgery is the route taken for a fixed prolapse, while sclerotherapy covers the narrower case and the one clear durability point.
None of themProcedures fix the cause
Stool consistencyBiggest lever
Not publishedDurability ranking here
The prevention side
What keeps it away in Montreal
The levers that do the preventing, and the guide that covers how much the published evidence actually settles.
What people ask at the end of a course of treatment, which is the right time to ask it.
They can, and what decides it is mostly outside the clinic. The procedure removed tissue that already existed; it did not change the pressure, straining or stool consistency that produced it.
We are not going to rank them, because the published figures disagree enough that a ranking would be a choice rather than a finding. One review does note recurrence after sclerotherapy can be higher.
Removing tissue leaves nothing in that position to come down again, which is a reasonable generalisation. It still does nothing about the pressures that produced the first one.
Stool consistency, which means fibre and fluid together rather than either alone. After that, less time spent sitting on the toilet, which costs nothing and most people have not tried.
Not necessarily. Recurrence is a feature of the condition rather than evidence of a failed procedure, which is why the prevention conversation happens at the review appointment.
No. Office procedures are what grades one to three that have not settled are for, and taking on an anaesthetic and a longer recovery to pre-empt a recurrence is a poor trade.
Recurrence
Treatment and prevention are two jobs
Procedures treat tissue
Every option here addresses tissue that already exists. None of them changes the pressure that produced it.
Nothing is permanent
A procedure presented as the end of it is overselling, whichever procedure is being presented that way.
No durability ranking
The published figures disagree enough that ranking them would be a choice rather than a finding.
The levers are yours
Stool consistency and time on the toilet decide most of this, and both sit outside the clinic entirely.
The recurrence conversation belongs at the review appointment, once the course is finished and there is something specific to prevent rather than a general warning.
