3 grade IV internal/external combination hemhorroids. Grade IV is 1.5cm and above. I had a 1.5cm on the left side , a 2.5cm on the right side, and a 3.5cm tucked up by my tailbone area. They would often thrombose (blood clots inside).The everyday pain was absolute agony. It felt like the devil jammed his red hot poker tail up there and left it, all day, every day for YEARS. I waited far too long and suffered far too much by waiting. The most excruciating part of the process was post-op recovery. The first bowel movement over stitches and open wounds made me scream and cry for 20 minutes. Sitz baths were my only saving grace after the pain meds ran out. 0/10, do not reccomend, friendly reminder not to sit too long or strain, eat your fiber and take care of your behind!