biostudies-literatureUnknown77(5)Gallo GUniversità degli Studi di Roma La SapienzaPolidocanol foam sclerotherapy has gained increasing attention as a minimally invasive treatment for hemorrhoidal disease (HD). However, significant variability exists in its clinical application regarding patient selection, procedural techniques, and postoperative management. This study aimed to assess real-world practice patterns among international experts, summarize existing evidence through a systematic literature review, and develop evidence-based clinical practice recommendations. A systematic review was conducted in MEDLINE, EMBASE, and CENTRAL to identify studies evaluating polidocanol foam sclerotherapy for HD. A total of 20 studies met the inclusion criteria. Additionally, an international survey was distributed to 30 experts in proctology and colorectal surgery to explore variaUpdates in surgery1439-1450https://www.ebi.ac.uk/biostudies/studies/S-EPMC12420758biostudies-literatureReal-world use of polidocanol foam sclerotherapy for hemorrhoidal disease: insights from an international survey and systematic review with clinical practice recommendations.PMC12420758Tutino RWu JLobascio PDe Parades VWang CSkowronski AMoser KHPozzo MGrossi USun PZhao SGravante GPerinotti RGallo GWang ZLa Torre MRealis Luc AFernandes VDe Simone VPicciariello ALi JHe HSileri PZeng XFan PRen DLaforgia RPata FZhang YDiaco EMa HLin HSalgueiro PTrompetto MfalseReal-world use of polidocanol foam sclerotherapy for hemorrhoidal disease: insights from an international survey and systematic review with clinical practice recommendations.Polidocanol foam sclerotherapy has gained increasing attention as a minimally invasive treatment for hemorrhoidal disease (HD). However, significant variability exists in its clinical application regarding patient selection, procedural techniques, and postoperative management. This study aimed to assess real-world practice patterns among international experts, summarize existing evidence through a systematic literature review, and develop evidence-based clinical practice recommendations. A systematic review was conducted in MEDLINE, EMBASE, and CENTRAL to identify studies evaluating polidocanol foam sclerotherapy for HD. A total of 20 studies met the inclusion criteria. Additionally, an international survey was distributed to 30 experts in proctology and colorectal surgery to explore varia2025-01-01T00:00:00Z2025 Sep2026-06-02T20:24:41.69Z2026-04-20T03:10:03.619ZS-EPMC124207584048124510.1007/s13304-025-02258-2