Inclusion Criteria:  Symptomatic patients who applied to the general surgery outpatient clinic due to stage 2 or 3 hemorrhoidal disease, unresponsive to medical treatment Patients who have not undergone any previous surgery due to hemorrhoidal disease Patients with written informed voluntary consent forms  Exclusion Criteria:  Concomitant anorectal disease History of anticoagulant use Fecal incontinence complaint History of active steroid/immunosuppressive use for any reason Pregnancy Inflammatory Bowel Disease