Hemorrhoidectomy
What is Hemorrhoidectomy ?
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Why do you need Hemorrhoidectomy ?
Hemorrhoids are classified as internal (inside the rectum) or external (under the skin around the anus), and graded by severity (I–IV). Hemorrhoidectomy is indicated for:
- Grade III–IV internal hemorrhoids: Large, prolapsing hemorrhoids causing persistent bleeding, pain, or mucus discharge.
- External hemorrhoids: Thrombosed (clotted) or causing severe pain/swelling.
- Failed non-surgical treatments: After unsuccessful attempts with dietary changes, medications (e.g., hydrocortisone), or procedures like rubber band ligation or sclerotherapy.
- Complications: Strangulation, thrombosis, or chronic bleeding leading to anemia.
Why Do Costs Vary in Philippines?
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Hemorrhoidectomy Procedure
The procedure is typically performed as a day-care or short-stay surgery:
- Before Procedure Evaluation:
- Diagnosis is confirmed via:
- Physical examination: Visual inspection or digital rectal exam to assess hemorrhoid size and location.
- Anoscopy or proctoscopy: Visualizes internal hemorrhoids and rules out other conditions (e.g., fissures, fistulas).
- Colonoscopy: Recommended for patients over 50 or with risk factors (e.g., family history of colorectal cancer) to exclude malignancy.
- Blood tests ensure surgical fitness, particularly for patients with comorbidities or anemia.
- Bowel preparation (enemas or laxatives) reduces contamination during surgery.
- Patients are counseled on post-operative pain management, diet, and hygiene.
- Diagnosis is confirmed via:
- Surgical Techniques:
- Conventional (Open or Closed) Hemorrhoidectomy:
- Performed under general, spinal, or local anesthesia with sedation, lasting 30–60 minutes.
- The patient is positioned in the lithotomy (legs raised) or prone position.
- The surgeon excises the hemorrhoidal tissue, including external skin tags or internal hemorrhoids.
- Open method: The wound is left open to heal naturally, reducing infection risk but prolonging healing.
- Closed method: The wound is sutured, promoting faster healing but with a slight risk of breakdown.
- Stapled Hemorrhoidopexy (PPH):
- A less invasive approach for internal hemorrhoids, using a circular stapling device to remove excess tissue and reposition the hemorrhoids.
- Reduces post-operative pain and recovery time but is costlier and unsuitable for external or thrombosed hemorrhoids.
- Takes 20–40 minutes under anesthesia.
- Laser Hemorrhoidectomy:
- Uses a laser to vaporize or excise hemorrhoidal tissue, minimizing bleeding and pain.
- Suitable for smaller hemorrhoids, offering faster recovery but higher costs.
- Available in advanced centers like Apollo or Fortis.
- Doppler-Guided Hemorrhoidal Artery Ligation (HAL-RAR):
- A non-excisional method ligating the arteries supplying the hemorrhoids, reducing their size.
- Less common, used for grade II–III hemorrhoids, with minimal tissue removal.
- Conventional (Open or Closed) Hemorrhoidectomy:
- After Procedure:
- Patients are monitored for a few hours to ensure recovery from anesthesia and pain control.
- Pain medications (e.g., paracetamol, ibuprofen, or opioids for severe pain) and stool softeners (e.g., lactulose) ease bowel movements.
- Sitz baths (warm water soaks) 2–3 times daily reduce pain and promote healing.
- Follow-up visits assess wound healing and symptom relief.
Recovery After Hemorrhoidectomy
Recovery is relatively quick but requires careful adherence to post-operative care:
- Hospital Stay:
- Most patients are discharged the same day (outpatient) or within 24 hours.
- Stapled or laser procedures may allow earlier discharge; open surgery may require a 1–2 day stay for pain management.
- Post-Procedure Care:
- Pain is significant for 1–2 weeks, especially during bowel movements, managed with oral painkillers, sitz baths, and topical anesthetics (e.g., lignocaine).
- Stool softeners and high-fiber diets prevent constipation and reduce strain.
- The anal area must be kept clean and dry; patients are advised to shower after bowel movements or use wet wipes.
- Antibiotics are rarely needed unless infection is suspected.
- Activity and Diet:
- Light activities (e.g., walking) resume within 1–2 days; strenuous activities (e.g., heavy lifting, sports) are avoided for 2–4 weeks.
- A high-fiber diet (fruits, vegetables, whole grains) and 2–3 liters of water daily promote soft stools.
- Avoid spicy foods, alcohol, or caffeine, which may irritate the bowels or worsen pain.
- Follow-Up:
- Follow-up visits at 1–2 weeks and 4–6 weeks assess wound healing and symptom resolution.
- Conventional hemorrhoidectomy wounds heal in 4–8 weeks; stapled or laser procedures heal faster (2–4 weeks).
- Long-term follow-ups are rare unless complications (e.g., recurrence, stenosis) occur.
Most patients resume normal activities within 1–3 weeks, with 90–95% experiencing symptom relief. Recurrence is rare (5–10%) with proper surgery and lifestyle changes.
Risks and Complications
Hemorrhoidectomy is a low-risk procedure but carries potential complications:
- Surgical Risks:
- Bleeding, usually minor but rarely requiring reoperation.
- Infection at the surgical site, treated with antibiotics or drainage.
- Post-Operative Complications:
- Urinary retention (5–10%), particularly after spinal anesthesia, often temporary.
- Anal stenosis (narrowing), requiring dilatation or further surgery.
- Fecal incontinence (rare, <1%), typically minor and temporary, due to sphincter injury.
- General Risks:
- Adverse reactions to anesthesia.
- Delayed wound healing, particularly with open hemorrhoidectomy.
- Long-Term Issues:
- Recurrence of hemorrhoids (5–10%), especially if dietary or lifestyle factors (e.g., constipation) persist.
- Chronic pain or discomfort, rare with proper technique.
Prompt reporting of symptoms like excessive bleeding, fever, or urinary issues ensures timely management.
Frequently Asked Questions (FAQs)
What causes hemorrhoids to require surgery?
Severe (grade III–IV) or thrombosed hemorrhoids causing persistent bleeding, pain, or prolapse, unresponsive to non-surgical treatments, require hemorrhoidectomy.
Can hemorrhoids be treated without surgery?
Yes, grades I–II hemorrhoids often respond to diet (high fiber), sitz baths, medications, or procedures like rubber band ligation. Surgery is for severe or complicated cases.
Is stapled hemorrhoidopexy better than conventional hemorrhoidectomy?
Stapled hemorrhoidopexy causes less pain and faster recovery but is costlier and unsuitable for external or thrombosed hemorrhoids. Conventional surgery is more versatile.
How soon can I resume normal activities?
Light activities resume in 1–2 days; normal routines (work, driving) resume in 1–3 weeks.
Is hemorrhoidectomy covered by insurance in India?
Most insurance plans cover hemorrhoidectomy for severe or symptomatic cases. Confirm with your provider.
What are the signs of complications post-hemorrhoidectomy?
Excessive bleeding, fever, severe pain, urinary retention, or difficulty controlling bowel movements require immediate medical attention.
Can hemorrhoids recur after hemorrhoidectomy?
Recurrence is uncommon (5–10%) with proper surgery, but persistent constipation or straining increases the risk.
What lifestyle changes are needed post-hemorrhoidectomy?
Maintain a high-fiber diet, stay hydrated, avoid straining during bowel movements, and practice good anal hygiene to prevent recurrence.
Conclusion
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Looking for Best Hospitals for Hemorrhoidectomy
Note: we are not promoting any hospitals
We do not promote any hospitals. All details are sourced from Google and hospital websites. Please verify independently. Start with your surgery—here’s the list of government, budget, and superspecialty hospitals accredited by the Department of Health (DOH), Philippine Health Insurance Corporation (PhilHealth), and Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₱) | Maximum Price (₱) |
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Angeles City |
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Antipolo |
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Bacolod |
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Bacoor |
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Baguio |
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Butuan |
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Cagayan de Oro |
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Caloocan |
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Cebu City |
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Dasmariñas |
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Davao City |
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General Santos |
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General Trias |
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Iligan |
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Iloilo City |
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Las Piñas |
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Makati |
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Malolos |
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Manila |
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Muntinlupa |
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Parañaque |
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Pasay |
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Pasig |
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Puerto Princesa |
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Quezon City |
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San Fernando |
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San Jose del Monte |
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Taguig |
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Valenzuela |
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Zamboanga City |
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Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.