Hemorrhoidectomy

Surgery 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.

What To Expect

Recovery takes about 2 to 3 weeks.

• You can expect some pain after surgery. If your doctor gave you a prescription medicine for pain, take it as prescribed. Ask your doctor what over-the-counter medicines are safe for you.
• Some bleeding is normal, especially with the first bowel movement after surgery.
• Some doctors may recommend that you take an antibiotic (such as metronidazole) after surgery to prevent infection and reduce pain.
• Follow-up exams with the surgeon usually are done 2 to 3 weeks after surgery to check for problems.

Why It Is 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 Well It Works

Surgery usually cures a hemorrhoid. But the long-term success of hemorrhoid surgery depends a lot on how well you are able to change your daily bowel habits to avoid constipation and straining. About 5 out of 100 people have hemorrhoids that come back after surgery.^{footnote 1}

Risks

Pain, bleeding, and not being able to urinate (urinary retention) are the most common side effects of hemorrhoidectomy.

Other relatively rare risks include the following problems.

Early problems

• Bleeding from the anal area
• Collection of blood in the surgical area (hematoma)
• Not being able to control the bowel or bladder (incontinence)
• Infection of the surgical area
• Stool trapped in the anal canal (fecal impaction)

Late problems

• Narrowing (stenosis) of the anal canal
• Return of hemorrhoids
• An abnormal passage (fistula) that forms between the anal or rectal canal and another area
• Rectal prolapse, which happens when the rectal lining slips out of the anal opening