It is not a procedure that is undertaken lightly, nor is it recommended as a first or even second medical procedure. A Hemorrhoidectomy is done when non-surgical medical procedures have failed to bring about relief for a patient.
There are four stages of severity for Internal hemorrhoids;
1st Stage - bleeding with defecation.
2nd Degree - bleeding with defecation and hemorrhoids protrude past the anal opening with defecation and return on their own to the inside position once a patient stops straining.
3rd Degree - hemorrhoids become swollen and prolapsed through the anal opening, have to be pushed back inside with gentle pressure.
4th Degree - hemorrhoids become thrombosed ( have a blood clot that is extremely painful), protrude and cannot be pushed back inside.
When a patient presents with 3rd and 4th degree
hemorrhoids, a Hemorrhoidectomy is recommended when all other procedures fail to work. External hemorrhoid
sufferers can also be candidates for a Hemorrhoidectomy when they cannot find relief through traditional
As in most surgical procedures, Hemorrhoidectomy is done under anesthesia. Depending on the patient, the facility, and the severity of the hemorrhoids, a Hemorrhoidectomy is done with general, spinal or local anesthesia.
The patient is placed on their back with feet in
stirrups, or on their stomach with their buttocks raised for access. The anal area is shaved and cleaned, then the
doctor will place a stabilize the hemorrhoid using clamps, the hemorrhoid is tied off and cut away, and the
hemorrhoid is removed.
Hemorrhoidectomy procedures have advanced in recent years; there are now surgical procedures where the hemorrhoid is removed by the use of an ultrasonic scalpel. Another form of Hemorrhoidectomy is the use of staples, although this procedure known as Stapled Hemorrhoidectomy has a reputation of having more complications than the traditional tied off method.
Here is a video showing a Hemorrhoidectomy Procedure:
The recovery period for a Hemorrhoidectomy can vary for each patient, but the time frame is usually 6-8 weeks. Recovery times for a Stapled Hemorrhoidectomy is less, but the chance of complications like rectal prolapse is greater.
You should take off work for at least two weeks after surgery, and do absolutely no lifting for three weeks.
That said, now for the meat of the matter. People who have undergone a Hemorrhoidectomy will tell you the pain is the worse they have ever suffered. For the first two weeks after a Hemorrhoidectomy pain medication is required. You should ensure before the Hemorrhoidectomy is done that your doctor is not going to tell you any different. They should be completely truthful about the pain after surgery, the pain when you first try have a bowel movement and exactly how strong the pain is. Any doctor who tells you will be fine after only 2 or 3 days post operative care after a Hemorrhoids surgery is not being honest.
The best way to prepare for the recovery period is to psyche yourself up for the worst and hope for the better. Once the recovery period for a Hemorrhoidectomy is over, you will be better off, and with a life style change or two you never have to worry about hemorrhoids again.
You should keep active as much as possible during the surgery recovery period. Unlike skeletal surgeries, you cannot really give the bowels a rest after surgery, and the higher activity level will allow a speedier healing, and reduce the pain quickly. You should be completely pain-free in two or three weeks.
Along with pain medications after surgery, you will
receive stool softeners. You should try and eat as healthy as possible during this time frame, and drink loads of
clear fluids. You need to move your bowels, and the wound will make this difficult, but plenty of water, stool
softeners, and a good diet will help make the move easier.
Wound Closure - The surgery leaves a wound in the rectal canal; if it does not close properly or it heals with heavy scar tissue, problems can begin. If you have any of the following symptoms, seek medical assistance immediately!
Bleeding - Heavy bleeding is not normal and could mean the wound is not closing properly.
Pain - While a high level of pain is expected after a surgical procedure, excessive, debilitating pain is not. If you have taken the pain relievers your doctor prescribed, and received no relief, or the pain is spiking and remaining high on the pain meter, it is not normal.
Infection Signs - Surgical sites tend to be warm to the touch, red and swollen. It is when these symptoms persist and are accompanied by pus, mucous and excessive swelling and heat then infection may be an issue.
Time- If after two weeks of your hemroid removal, you are not feeling better, or feel as bad as you did when you first came home after the Hemorrhoidectomy, then return to the doctor and ask why!
Never be afraid to ask the doctor a question or voice a concern. As they are your primary health provider it is in your best interest to trust them, and believe in them and their skills. A Hemorrhoidectomy is a major surgery, and your doctor needs to know when you feel bad so he can assess the success of the surgery.