The Pros and Cons of Surgical Hemorrhoid Removal

The Pros and Cons of Surgical Hemorrhoid Removal

The surgical removal of hemorrhoids is a procedure known as a hemorrhoidectomy. While there are benefits to undergoing this surgery, it doesn’t come without drawbacks.

Before deciding to have removal surgery, it’s a good idea to weigh the pros and cons of surgical hemorrhoid removal. You may decide that a minimally invasive hemorrhoid procedure is a better option for you.

Pros of Surgical Hemorrhoid Removal

Doctors have been treating hemorrhoid patients with hemorrhoidectomies for many years. There are some good reasons why they might choose this approach to hemorrhoid removal.

You can learn about the procedure in the following video:

1. Hemorrhoidectomies offer long-term success.

One of the top reasons that colorectal specialists rely on hemorrhoidectomies is that the procedure is reliable. Removing the hemorrhoidal tissue from the body — also known as an excision — is a highly effective method of resolving the condition.

Many patients continue to be free of hemorrhoid trouble long after having the surgery performed. Some never experience a recurrence.

2. Surgery is useful for complicated hemorrhoids.

Some hemorrhoids are fairly mild. Although they might cause unpleasant symptoms, the inflammation may clear up after a few days of home care. Medical interventions aren’t always necessary.

Other times, though, hemorrhoids become more problematic. They may cause recurring symptoms, such as bleeding, itching and irritation. As hemorrhoids grow larger, they may prolapse out of the anal opening. In such cases, patients often become eager to do something about the issue.

The most serious hemorrhoids prolapse out of the rectum most or all of the time. At that point, minimally invasive hemorrhoid procedures aren’t necessarily the best fit. A hemorrhoidectomy may be more appropriate.

Surgical excisions can also be useful for patients who have had repeated hemorrhoid occurrences. Often, alternative treatments have failed, and a hemorrhoidectomy offers the best chance of success.

Another complicated scenario involves having both internal and external hemorrhoids. Many minimally invasive procedures treat only the internal variety. A hemorrhoidectomy could be a promising approach to treating both sets of hemorrhoids.

3. It can be an outpatient procedure.

After a hemorrhoid excision, you may require a short observation period at the surgical center. The doctor may release you to go home the same day.

For patients who are concerned about the discomfort or cost of an extended hospital stay, the outpatient nature of this procedure might be much appreciated.

Cons of Surgical Hemorrhoid Removal

While the above list of pros might be nudging you toward a hemorrhoidectomy, there are some key concerns that you'll want to consider first.

1. An enema is often required.

You can’t simply show up on surgery day and undergo a hemorrhoidectomy. Instead, you’ll have to clear out the lower part of your colon first.

Doctors usually prescribe an enema treatment to ensure that the patient's rectum is as empty as possible. As a result, patients may spend a great deal of time in the restroom the night before a hemorrhoidectomy.

2. The recovery can be rough.

Unfortunately, the unpleasantness surrounding a hemorrhoidectomy doesn’t end as soon as the surgery is over. It can take a few weeks to feel better after having this procedure done.

Common problems during the recovery period include pain, bleeding, anal discharge and bruises. You will need at least a week before you can resume normal activities. Even after that, you’ll probably continue to experience some side effects.

You may need to take prescription painkillers for several days to stay on top of the aches and pains associated with this surgery. The doctor may give you stool softeners as well since many people have trouble with bowel movements afterward.

For many people, full recovery can take at least a month. It’s often a two-month process.

3. There’s a risk of long-term complications.

In most cases, the recovery from surgical hemorrhoid removal is unpleasant but not serious. There are risks involved, though. Unfortunately, some people do suffer from major hemorrhoidectomy complications.

One of the most nerve-wracking possibilities is damage to the anal sphincter. If that happens, it can result in gas or stool incontinence.

There’s also a small chance that your post-surgical pain won’t resolve.

Other concerns include anal stenosis, fistulas or fissures. While treatment can help these conditions, it may require another round of colorectal surgery.

An Alternative to Surgical Hemorrhoid Removal

Yes, there are some benefits to surgical hemorrhoid excision, but the drawbacks could leave you hesitant to proceed. Fortunately, hemorrhoid removal surgery isn’t your only option for effective treatment.

One of the most promising options is rubber band ligation. Offered as an in-office procedure, this involves using the Adler Ligator (AL 9000) or a similar instrument to slide a small rubber band around the hemorrhoid. It serves to restrict blood flow so that the tissue will wither and fall off.

This procedure offers several benefits over hemorrhoidectomy surgery:

  • Usually requires no bowel prep or anesthesia
  • Can often be completed in less than 10 minutes
  • May require only a couple of days for recovery

The hemorrhoidal tissue usually falls off within 1.5 weeks. Many patients experience a high level of success with this procedure, and the scar tissue that remains can help prevent future recurrences.

Your Hemorrhoid Removal Decision

Choosing whether to have surgical hemorrhoid removal should be a decision between you and your doctor. You may be a better candidate for hemorrhoid banding with the Adler Ligator. Visit our Find a Doctor page to locate a specialist near you who can help you identify the best hemorrhoid removal procedure for your needs.

As with all medical issues, your physician is the ultimate source as to what procedure best fits your needs. Discuss all options and get a second opinion if you have any doubts. These articles are intended to be a source of general information only.

Brian Chandler