Hemorrhoidectomy
Hemorrhoidectomy is a surgery to remove hemorrhoids - enlarged veins that is found in and around the rectum and anus. Hemorrhoids may result from straining frequently due to constipation or child birth. Hemorrhoids can be classified into two types namely - external and internal. While external hemorrhoids occur below the anal sphincter and protrude at the anus, internal hemorrhoids occur above the anal sphincter and may be classified as first, second, third or fourth degree. External thrombosed hemorrhoids cause pain and they contain clotted blood. Normally the thrombosed external hemorrhoids are incised and the clot evacuated.
Hemorrhoidectomy becomes necessary when conservative measures fail to alleviate the severe burning, itching, swelling, protrusion, bleeding and pain in the anal area. Hemorrhoidectomy becomes appropriate when there are very large internal hemorrhoids, sometimes when internal hemorrhoids continue to cause symptoms after surgical treatment, when large external hemorrhoids cause significant discomfort in the anal area.
During the surgical procedure of hemorrhoidectomy, general anesthesia or spinal anesthesia is administered on the patient so that no pain is felt. Incisions are made in the tissue around the hemorrhoid. The hemorrhoid is removed and the swollen vein inside the hemorrhoid is tied off to prevent bleeding. The surgical area could either be closed with suture or left open. Surgery is performed using a scalpel, a cautery pencil or laser. Sometimes a circular stapling device is used to remove the hemorrhoid and close the wound. Here no incision is made. The hemorrhoid is lifted and stapled into place in the anal area. Recovery from hemorrhoidectomy may take about two to three weeks.
Normally the patient experiences pain after surgery . The doctor prescribes medicine to alleviate the pain. Some bleeding is normal after hemorrhoidectomy is performed, especially with the first bowel movement. Ice packs are recommended to be applied in the anal area to reduce swelling and pain. Sitz bath, with frequent soaks in warm water helps to relieve pain and muscle spasms. Stool softeners that contain fiber may help to make bowel movements smooth.
Hemorrhoids are found to recur in about 5% after hemorrhoidectomy. Hematoma, incontinence and infection in the surgical area and fecal impaction are some of the early side effects of hemorrhoidectomy. Late problems of hemorrhoidectomy could include stenosis or narrowing of the anal canal, formation of fistula between the anal and the rectal canal and rectal prolapse when the rectal lining slips out of the anal opening.
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