Definition

Hemorrhoids are swollen (dilated) veins located in or around the anus and/or rectum. Hemorrhoids can cause discomfort, pain, or bleeding.

Hemorrhoid

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Hemorrhoidectomy is an operation to remove hemorrhoids.

Parts of the Body Involved

  • Anus
  • Rectum

Reasons for Procedure

If your hemorrhoid symptoms do not get better with other therapies, it may be necessary to have a hemorrhoidectomy to remove them.

Risk Factors for Complications During the Procedure

  • Bleeding disorder
  • Advanced age
  • Prior anal surgery
  • History of fecal incontinence (involuntary leaking of stool)

What to Expect

Prior to Procedure

  • Do not eat or drink anything after midnight.
  • Your doctor will order a laxative for you to take which will cleanse your colon and rectum.
  • Do not use aspirin or other NSAIDs (nonsteroidal anti-inflammatory medications) for one week before your surgery.
  • Discuss all your medications with your doctor, even non-prescription medications.
  • Arrange for someone to take you home after the surgery.
  • If you have diabetes , discuss your medications with your doctor.
  • If you are on blood thinning medications, discuss them with your doctor.

Anesthesia

Your surgery will be done using either spinal anesthesia or general anesthesia . Both types of anesthesia will make your surgery painless. Discuss these options with your doctor before the day of your surgery.

Spinal anesthesia will make you numb from the mid-abdomen down.

General anesthesia will keep you unconscious throughout the surgery.

Description of the Procedure

First, your doctor will insert an anoscope into your anus. Through the anoscope, he or she will be able to see the hemorrhoids.

Next, your doctor will make an incision around each hemorrhoid. He or she will then tie off the swollen vein inside the hemorrhoid so that it does not bleed and remove the hemorrhoid. After the hemorrhoids are removed, the wounds will either be stitched closed or left open to heal.

There are other variations of this procedure such as the PPH hemorrhoidectomy which uses a circular stapling device to remove the hemorrhoids. Ask your doctor to describe which procedure will be used.

After Procedure

Hospital staff will monitor you in a recovery area for a few hours. Then, you will go home.

How Long Will It Take?

The procedure will take 1-2 hours.

Will It Hurt?

You should feel no pain during the procedure. After the procedure, you might have pain in the surgical area. Your doctor will give you pain medications if you need them.

Possible Complications

  • Bleeding
  • Loss of bowel or bladder control
  • Infection
  • Severe constipation
  • Anal impaction (stool that is trapped within the anus)
  • Narrowing of the anal canal
  • Recurrence of hemorrhoids
  • Fistula formation (formation of an abnormal passage between the rectum or anus and another area)

Average Hospital Stay

There is no stay associated with this procedure.

Postoperative Care

Your doctor will ask you to:

  • Take sitz baths (sit in a tub of shallow warm water) several times a day.
  • Use stool softeners.
  • Apply ointments to the area.
  • Avoid all heavy lifting for a period of time.
  • Take pain medication as needed.

Outcome

Complete recovery will take 2-3 weeks. If your surgery is successful, you should have relief from your symptoms. If your hemorrhoids come back, let your doctor know.

Call Your Doctor If Any of the Following Occurs

  • Develop bleeding
  • Cannot urinate
  • Develop a fever
  • Cannot pass bowel movements