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As you mentioned that Hemorrhoids comes out , this is suggestive of fact that you have Grade 4 Hemorrhoids and in this case nothing is effective other than surgery .
Option to manage Hemorrhoids are either sclerotherapy or Hemorrhoidectomy .
Sclerotherapy in which injection is given to make piles shrink is not option in your case as you have Grade 4 prolapsed piles.
option available for you is Hemorrhoidectomy ( Surgical treatment ) .
So it would be ideal for you to proceed with it , this can even be done in spinal anesthesia .
Go for that .
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