Polidocanol foam sclerotherapy for hemorrhoidal disease in a private outpatient setting: a real-world single-center study combining chart review and WhatsApp-delivered patient-reported outcomes.

BACKGROUND: Polidocanol foam sclerotherapy (PFS) is an effective office-based treatment for symptomatic hemorrhoidal disease (HD), but real-world data from private practice and patient-reported outcomes (PROMs) at variable follow-up are scarce. METHODS: We retrospectively reviewed all consecutive patients treated with PFS (3% polidocanol, Tessari method) in a single private proctology office (December 2021-May 2026). Indication was primarily symptom-driven rather than based on Goligher grade. Two data sources were combined: session-level chart review and a structured digital questionnaire (Google Forms) delivered through a personalized WhatsApp invitation, exploring symptoms before and after treatment, post-procedural discomfort and satisfaction. Outcomes were also explored by time since the last session. RESULTS: Eighty-four patients underwent 118 sessions (65.5% single). The survey response rate was 65.5% (55/84; median time from last treatment 64 days, range 1-1,438). Among patients symptomatic at baseline, improvement or resolution was reported by 95.8% (46/48) for bleeding, 97.4% (37/38) for heaviness/pain and 86.4% (38/44) for prolapse (composite 121/130, 93.1%). No or mild post-procedural discomfort was reported by 89.0%, overall satisfaction was 94.5%, and no severe discomfort was reported; no major adverse event was reported or documented. Chart review captured in-office follow-up after 38.1% of sessions, with persistence/recurrence in 63.4% of classifiable encounters. Chart and PROM estimates used different units and are not directly comparable; their discrepancy suggests return-to-clinic ascertainment bias. CONCLUSIONS: Among respondents, PFS achieved high patient-reported symptom control and satisfaction. A WhatsApp-delivered PROM survey was feasible and may reduce the bias of clinic-return-based follow-up.