Blog - What is a Haemorrhoidectomy

What is a Haemorrhoidectomy?

A haemorrhoidectomy is a surgical operation performed to remove severe haemorrhoids (internal or external) from sufferers. It is considered the most effective form of surgery aimed at haemorrhoid removal, though it also comes with the highest rate of complications and often a significant amount of pain.

The Procedure

There are several forms of haemorrhoidectomies available to patient which a doctor may recommend.

A closed haemorrhoidectomy, to begin with, is the most common method. It involves the removal of a haemorrhoid using a scalpel or scissors, or in more extreme cases, electrocautery or laser treatment, after which the resulting wound is closed over using a suture. This form of treatment has a 95% success rate.

Next, an open haemorrhoidectomy involves the removal of a haemorrhoid in the same manner as with the closed haemorrhoidectomy, except the wound is left open. This option is sometimes preferred in cases where performing a closed haemorrhoidectomy is problematic or may result in infection occurring. In many cases, medical professionals use a combination of the open and closed approaches when removing a haemorrhoid.

A third option is a stapled haemorrhoidectomy, which is also known as Longo’s procedure or the circular stapler haemorrhoidopexy. This form of the procedure is most often recommended for patients suffering from grade III or IV haemorrhoids, or for those for whom other forms of treatments have failed. In this approach, a stapling device is used to remove a round ring of haemorrhoid tissue and return the remainder of the haemorrhoid to its usual place in the anus. Stapled haemorrhoidectomies are associated with fewer post-operative complications and a reduced recovery time, but have a higher rate of recurrence than other versions of the haemorrhoidectomy procedure.

Complications

As with many surgical approaches to tackling haemorrhoids, there are a number of potential complications. These include post-operative pain, delayed bleeding, fecal impaction, involuntary emission of faeces or gas, urinary retention, urinary tract infection, and in some cases, infection, inflammation, and anal stricture. Haemorrhoidectomies often produce the most discomfort following the operation, but they are the most likely to successfully remove haemorrhoids in the long-term.

Recovery 

Those who undergo a haemorrhoidectomy will experience a degree of ache in the anus and rectum for two to four weeks, or more, and may require painkillers to get them through that period. Recovering patients may also experience bleeding or fluid emission from the anus, which is most likely to occur during or after a bowel movement. This can continue intermittently for up to two months after haemorrhoid surgery. As in the case of most surgeries, it’s important to avoid doing activities that involve a high degree of effort, especially heavy lifting. Most patients can go about their usual routines within a fortnight of surgery.

Good self-care is vital in the days, weeks and months following a haemorrhoidectomy. Recovering patients should remain active by going for walks or doing light yoga, but should always rest when they begin to feel tired. Continue to maintain a high level of hygiene and take care to pat rather than rub the anal region dry after having a shower or bath. Most people will require a week or two off work to recover.

Keep your diet high in fibre following surgery to avoid getting constipated and exacerbating your pain further – the easier your bowel movements are, the less pain you’ll feel. Drink plenty of fluids and use stool softeners or laxatives (if recommended by your doctor). You may also be directed to try blood-thinning medication such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin in order to aid in your recovery.

Not everyone will experience the same sort of recovery, in terms of length and discomfort – here’s how one haemorrhoidectomy patient described what happened to them after their operation:

“I had no clue the impact that having haemorrhoids would have on my life and certainly no idea of the pain I would go through after the haemorrhoidectomy.  If I had my time over, I’m not sure if I’d say yes to the operation or learn to manage the pain I was going through before.

“I don’t want to scare people who are considering a haemorrhoidectomy but I do think that people should be aware that this is not just a small operation – far from it.  My specialist and my GP both glossed over the facts of how long I could be in pain for and gave me best case scenarios when I spoke to them before the operation – they said that I would ‘probably’ only be off work for a few weeks and I was in no way mentally prepared for everything I was about to go through.” Click Here

Another haemorrhoidectomy patient wrote:

“I was told I’d be “uncomfortable” for a few days, and would need a couple of weeks off work. Cleverly I scheduled the op for just before the Easter holidays, thinking I’d be able to have a lovely time with the children, then back to work when they went back. I spent the whole time in agony, but am pretty sure I must have started to do the school run, etc, when they went back. It does get better, just very slowly, as every poo has to smash its way through the operating site.” Click Here

In some cases, if your post-operative symptoms persist for an extended period of time or worsen noticeably, you may need to contact your doctor. However, you will need to seek emergency assistance of you experience any of the following symptoms:

• Fainting
• Shortness of breath
• Increased swelling or inflammation
• Increased pain (especially that which doesn’t recede after using painkillers)
• Excessive bleeding or fluid emission from the haemorrhoid area
• Fever
• Stomach sickness and inability to keep fluids down
• Pain in your calves, knees, thighs or groin (signs of blood clot)
• Redness or swelling in the aforementioned regions
• Inability to pass stool or gas

A haemorrhoidectomy is a serious and often painful surgical procedure, so take all options into account before settling on this approach, and heed your doctor’s advice.