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On examination, we found this: In this case, the only way to reduce the prolapse is a procedure for prolapsing hemorrhoids PPH which is an worst anal prolapse ever approach to the management of enlarged, prolapsing hemorrhoids. Rather than rely on excision worst anal prolapse ever the complexes, the primary goal is to reduce the hemorrhoidal tissue and anoderm to the correct anatomical location within the anal canal. It is important to keep this goal in mind, because the misinterpretation of anodermal migration externally as external hemorrhoids leads to unnecessary excision of sensate skin during PPH. In fact, with a correctly performed procedure, the relocated anoderm will shrink over time.