Depends on the degree of prolapse and whether they are internal or external.
Internals tend to be painless and can be treated by in-office techniques like rubber banding, irc, injection sclerotherapy
. With associated prolapse or external components, thd and stapled pph are the procedures of choice for most grade 2-3 hems. Kstandard surgicall hemorrhoidectomy is reserved for large grade 3-4 hems.