Circular stapled mucosectomy (CSM) ( Longo procedure), offers a new approach in the surgical treatment of hemorrhoids. Circumferential resection of rectal mucosa causes hemorrhoids blood supply cut off as well as lifting nodes up in the anal canal. Long term observations show good clinical outcome, some publications however reported incidents of persistent, postoperative fecal urgency. The aim of the study was to assess manometric and clinical findings in patients complaining of fecal urgency after CSM. Material and methods: Study was approved by local Bioethics Commission. 24 patients with symptomatic hemorrhoids, who were qualified for CSM, were enrolled into the study. 5 (20,8%) patients had II° hemorrhoids, 13 (54,2%) - III° and 6 (25%) - IV°. Apart from standard proctologic and endoscopic examinations, all patients underwent anorectal manometry before surgery and 3 months after CSM. Parameters measured during manometry were: - maximum resting anal pressure (MRAP) - maximum squeeze anal pressure (MSAP) - high pressure zone length (HPZL) - volume of first rectal sensation (VIRS) - volume of constant rectal sensation (VCRS) - maximum tolerable volume (MTV) None of the patients reported any incidents of fecal urgency before surgery. Results: 3 months after surgery 7 (29,1%) patients (group B) reported symptoms of fecal urgency. No differences were found between patients without fecal urgency (group A) in proctologic and endoscopic exams. Stapling line distance from verge of dentate line was: in group A - 31 mm (24 - 41mm, SD 4,82), in group B - 30 mm (23 - 39mm, SD 4,91) Results of anal manometry in both groups are shown in table 1. All patients completed a follow-up visit 6 months after surgery. In all cases fecal urgency receded completely. Conclusions: Fecal urgency after CSM may be caused by decrease of rectal ampulla volume. However reasons for the urgency can be multifactorial, thus requiring further investigations.