Haemorrhoid surgery is suitable for certain types of haemorrhoids (piles) where less invasive treatments (such as rubber band ligation or injection of sclerosing substance) are not suitable or have not worked. This is more often the case when there is a large external component to the haemorrhoid. There is a spectrum of operations which may be considered for treating haemorrhoids.
Conventional haemorrhoidectomy involves the excision (removal) of the internal and external haemorrhoids under general anaesthetic. The surgeon gently opens the anus and cuts away the haemorrhoid. The wounds may be stitched closed or left open.
Stapled haemorrhoidectomy, also known as a stapled anopexy or procedure for prolapse and haemorrhoids (PPH) is an alternative method of haemorrhoid removal. Part of the lower rectum, just above the haemorrhoid tissue, is excised using a circular stapling device. The defect is closed with small staples. This reduces the size of the haemorrhoids and can help to reduce the external part. However, it is not suitable for all types of haemorrhoid.
HALO is a relatively new procedure in which the arteries supplying the haemorrhoid is identified by a Doppler machine and a suture is placed to interrupt the blood supply to the haemorrhoid, causing it to shrink and be less likely to bleed. In addition, the procedure is usually combined with a recto-anal repair which reduces prolapsing tissue.
Your surgeon will discuss with you which operation is best for you.
WHAT TESTS ARE NECESSARY BEFORE THE PROCEDURE?
Your surgeon will sometimes want to check that the bowel above the haemorrhoids is normal and will recommend a telescope test such as a colonoscopy or flexible sigmoidoscopy.
HOW DO I PREPARE FOR THE SURGERY?
The hospital will contact you before your operation to arrange for you to come in for a pre-assessment visit. This normally lasts 30-60 minutes.
At your you visit will have some basic health checks to ensure you are fit for surgery. These may include:
- Blood Pressure
- Urine Analysis
- Electrocardiogram (ECG)
- Medical History Questionaire
- MRSA Screen
The nurse will advise whether you should continue to take any regular medication.
You will also be given instructions about when to stop eating and drinking before your operation, what to bring into hospital with you and when to arrive.
HOW LONG DOES IT TAKE TO RECOVER?
This depends on the exact operation, and the severity of haemorrhoids. You will usually be allowed home either the same day or after one night in hospital. You may wish to take two weeks off work, as pain in the back passage can be significant for some time. Often it is most painful 4-5 days after the surgery. You will be given painkillers when you leave hospital.
You may find that some pain persists for several weeks, but this should be controllable with painkillers.
Keep stools soft with a high fibre diet and/or laxatives to minimise discomfort.
HOw LONG DOES IT TAKE TO RECOVER?
The main risk from the operation is bleeding, which is a potential problem with all forms of haemorrhoid surgery.
A few spots of blood is a common post-operative event, but about 1 in 100 patients get bleeding which is heavier and does not stop. Typically, this occurs 3-7 days after surgery. If this is the case, you should seek medical advice (Please refer to FAQs for more information. Click here).
Rarely, other serious complications such as urinary retention (difficulty emptying the bladder), anal fistula (a channel opening up between the anus and skin), stenosis (narrowing of the anal canal) or faecal incontinence. Your surgeon will explain these risks before surgery.
Seek immediate medical advice if you experience fever (temperature above 37.5C), excessive bleeding, problems urinating or worsening pain or swelling around your anus.
Around 5% of people experience recurrence of their haemorrhoids after surgery.
Please be advised that the information on this website is not a substitute for professional medical advice, diagnosis or treatment