Thanks for query,
The permanent solution for piles is it's surgery.As you have some vessels out it is a prolapsed piles This needs surgery.
Usually this open surgery is performed with local block & it will not cause you pain.The dressing of wound should be done for at least 10 days.Staple surgery also done.
Now a days laser surgery
also done but the afterwards dressing remains in all methods as you have to pass stool needs it's cleaning.
Open surgery have more plus points.