Hemorrhoidectomy

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What is a Hemorrhoidectomy?

Hemorrhoidectomy is the surgical removal of enlarged veins in the lower rectum and anus (hemorrhoids).

How is it done?

During Hemorrhoidectomy the doctor makes incisions around the anus to cut away the hemorrhoids and gauze packing is inserted to reduce bleeding. Incisions may require stitching, which can cause the area to become tender and painful. Staples may be used in selected cases. It may be performed under a local anesthesia, which numbs the area around the anus, usually combined with intravenous sedation. Alternatively, a regional (spinal or epidural) or general anesthesia may be used.

Why is it done?

Hemorrhoidectomy may be recommended when non-surgical treatments have not provided adequate relief of symptoms such as itching, anal bleeding, pain, swelling and blood clots (thrombosis of the hemorrhoids) and infection. 

Risks & complications            

Hemorrhoid surgery is very common and has very few risks. However, as with any surgery, there are risks, including the possibility of:
  • Bleeding occurring immediately after surgery or 7-14 days after.
  • Infection requiring antibiotics.
  • Reaction to the anesthesia.
  • Difficulty urinating because the pain makes it difficult to relax and allow urine to flow.
Risks can be reduced by following the surgeon's instructions before and after surgery.

Alternatives

Some symptoms of hemorrhoids improve without treatment by keeping the stool soft with proper diet, adequate hydration and stool softeners.  Warm baths, over-the-counter creams, ointments or pads containing topical anti-inflammatory agents or hydrocortisone are effective in relieving mild discomfort. 

Other non-surgical treatments include:
  • Rubber Band Ligation:  one or two tiny rubber bands are placed at the base of an internal hemorrhoid to cut off its circulation and the hemorrhoid falls off.  This procedure, done in the doctor’s office, is effective for small and non-prolapsed hemorrhoids.
  • Sclerotherapy: A chemical solution is injected around the blood vessel to shrink the hemorrhoid.
Convalescence

The patient may experience considerable pain after surgery as the anus tightens and relaxes.  Medications to relieve pain and stool softeners may be used.  Avoid straining during bowel movement or urination.  Soaking in a warm bath can bring additional comfort.  Expect complete recovery in about 2 weeks.

 

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