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Hello,i'm thinking of removing my hemorrhoid by surgery, is it painful? does the recovery phase take time? and is there a possibility that i would have it again after the surgery?
7 مايو 2013

د. Zakia Dimassi طب الأطفال
Every operative procedure has benefits and risks. Hemorrhoidectomy (or hemorrhoid removal) has several techniques; the technique is chosen by the surgeon according to the stadge of the hemorrhoids and the surgeon's experience; so the complications will depend on the technique chosen.
The benefits are prevention of: protracted symptoms, bleeding (that may also lead to anemia), prolapse (internal hemorrhoids protruding out), necrosis of external hemorrhoids (the tssue dies) which is associated with sever pain especially with bowel movement.
You could expect minor post-operative bleeding, anal pain, infection at that area, inability to pass urine (urinary retention- mostly because of pain).
The risk of recurrent symptoms following such treatment varies with the extent of the disease, with a 10% recurrence rate for Stage I and II disease, and 30% for Stage III disease. Hemorrhoidectomy carries a 5% risk of recurrent symptoms.
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د. Antoine Younan الجراحة
Internal hemorrhoids are classified according to a system of grades.

Grade One internal hemorrhoids do not protrude from the anal canal, though they may cause other symptoms such as bleeding or itching.

Grade Two hemorrhoids are at the first stage of hemorrhoidal prolapse, which is to say that they protrude from the anal canal during a bowel movement but retract back into the body upon completion of said bowel movement.

Grade Three hemorrhoids protrude from the anal sphincter during a bowel movement and do not retract upon completion, but will stay inside if pushed back in manually. Grade Three hemorrhoids have a tendency to bleed more often and are generally easier to inflame.

Grade Four hemorrhoids protrude from the body all the time. If pushed back in, they will slip out on their own shortly with no effort required. Hemorrhoids this severe need to be seen by a doctor, as they bleed much more easily, are prime targets for infection, and may develop an internal blood clot, also known as thrombosis.

Grade one and two are treated medically.

Grade three and four are treated surgically.

There are multiple surgical technics. I advice the Longo procedure. Procedure for Prolapse and Hemorrhoids (PPH)

PPH uses a circular stapler to reduce the degree of prolapse. The procedure avoids the need for wounds in the sensitive perianal area thus reducing post-operative pain considerably, and facilitates a speedier return to normal activities.
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