Hemorrhoidectomy: Overview
Hemorrhoidectomy is surgery to remove hemorrhoids. These are swollen veins in the anal area. During this surgery, the doctor will cut out the swollen veins. After surgery, the pain and itching from your hemorrhoids should go away.
After this surgery, you will probably go home the same day. You will have some pain in your anal area. You may also have light bleeding from your anus. These symptoms may last for 1 to 2 months. Your doctor will give you medicine to help relieve your pain. Your doctor may also give you stool softeners. These help make your bowel movements easier.
Avoid heavy lifting for 4 weeks after surgery. You will probably need to take 1 to 2 weeks off from work. This depends on the type of work you do and how you feel.
Why is a hemorrhoidectomy done?
Hemorrhoidectomy may be done when you have:
- Very large internal hemorrhoids.
- Internal hemorrhoids that still cause symptoms after nonsurgical treatment.
- Large external hemorrhoids that cause a lot of discomfort and make it hard to keep the anal area clean.
- Both internal and external hemorrhoids.
- Had other treatments for hemorrhoids (such as rubber band ligation) that have not helped.
How is a hemorrhoidectomy done?
Hemorrhoidectomy is surgery to remove hemorrhoids. You will be given general anesthesia or spinal anesthesia so that you will not feel pain.
Incisions are made in the tissue around the hemorrhoid. The swollen vein inside the hemorrhoid is tied off to prevent bleeding. Then the hemorrhoid is removed. The surgical area may be sewn closed or left open. Medicated gauze covers the wound.
Surgery can be done with a knife (scalpel). Or it may be done with a tool that uses electricity (cautery pencil) or with a laser.
You will most likely go home the same day (outpatient).
Doppler-guided hemorrhoidectomy is a procedure that uses a scope with a special probe. The scope locates the hemorrhoidal arteries so that less tissue is removed. Some studies show that it is less painful. But more long term studies are needed to compare it with other procedures.
After the surgery
Right after the surgery, when you are still under anesthesia, you will be given a long-acting local anesthetic. It should last 6 to 12 hours to provide pain relief after surgery. If you are not going to stay overnight in the hospital after surgery, you will leave only after the anesthesia wears off and you have urinated. Inability to urinate (urinary retention) sometimes occurs because of swelling (edema) in the tissues or a spasm of the pelvic muscles.
Homorrhoidopexy
There is a procedure that uses a circular stapling device to remove hemorrhoidal tissue and close the wound. No incision is made. In this procedure, the hemorrhoid is lifted and then "stapled" back into place in the anal canal. This surgery is called stapled hemorrhoidopexy. People who have stapled surgery may have less pain after surgery than people who have the traditional hemorrhoid surgery. But the stapled surgery costs more. And people who have stapled surgery are more likely to have hemorrhoids come back and need surgery again.
Hemorrhoidectomy: When to call
Call 911 anytime you think you may need emergency care. For example, call if:
- You passed out (lost consciousness).
- You are short of breath.
Call your doctor now or seek immediate medical care if:
- You have signs of infection, such as:
- Increased pain, swelling, warmth, or redness.
- Red streaks leading from the area.
- Pus draining from the area.
- A fever.
- You have pain that does not get better after you take your pain medicine.
- You are sick to your stomach and cannot keep fluids down.
- You have signs of a blood clot in your leg (called a deep vein thrombosis), such as:
- Pain in your calf, back of the knee, thigh, or groin.
- Redness and swelling in your leg or groin.
- You cannot pass stools or gas.
Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.
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