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McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
Hemorrhoidectomy
What is a hemorrhoidectomy?
Hemorrhoids are veins in the tissues at the opening of the
anus that become enlarged. They can cause pain, bleeding,
and/or itching. If you have hemorrhoids, you may have clots
forming in the hemorrhoid tissue. Your bowel may treat the
clots like stool and try to push them out of your body.
A hemorrhoidectomy is a procedure in which the doctor
removes hemorrhoid tissue to remove clots and promote
healing.
When is it used?
Hemorrhoidectomy is one method of treating hemorrhoids.
Examples of alternatives to this procedure are:
- to use a laser to remove the hemorrhoids
- to place tight bands around the hemorrhoids
- to use a fluid to harden the hemorrhoids
- to freeze the hemorrhoids
- to try anesthetic ointments and/or sitz baths
- to choose not to have treatment, recognizing the risks of
your condition.
You should ask your doctor about these choices.
How do I prepare for this procedure?
Plan for your care and recovery after the operation. Allow
for time to rest and try to find people to help you with
your day-to-day duties.
Follow instructions provided by your doctor. Eat a light
meal, such as soup or salad, the night before the procedure.
Do not eat or drink anything after midnight and the morning
before the procedure. Do not even drink coffee, tea, or
water.
What happens during the procedure?
You are given either spinal or general anesthesia. The
spinal anesthetic will make you feel temporarily numb from
the chest down so that you have no pain during the
procedure. The general anesthetic relaxes your muscles,
makes you feel as if you are in a deep sleep, and prevents
you from feeling pain.
The doctor will put an anoscope (tubelike instrument for
examining the lower rectum and anal canal) into your anus
and expose the affected hemorrhoids. The doctor will cut
the inflamed parts of the hemorrhoids and remove them.
The doctor may also try to trim the lining of the rectum by
removing some extra tissue. He or she will check for any
bleeding. The doctor may sew the wounds closed or leave
them open to heal.
What happens after the procedure?
You may go home that day or may stay in the hospital 1 to
3 days, depending how fast you recover. You will need to
take sitz baths, use stool softeners, and apply ointments to
the area. Avoid all heavy lifting for 2 to 3 weeks. You
may return to work in a few days or weeks, depending on the
type of work. You may have trouble passing urine and
controlling gas and bowel movements for a few days after
this operation.
Ask your doctor what other steps you should take and when
you should come back for a checkup.
What are the benefits of this procedure?
You will be relieved of the itching, painful, and bleeding
hemorrhoids.
What are the risks associated with this procedure?
- There are some risks when you have general anesthesia.
Discuss these risks with your doctor.
- Spinal anesthesia may not numb the area quite enough, and
you may feel some minor discomfort. Also, in rare cases,
you may have an allergic reaction to the drug used in
this type of anesthesia. Spinal anesthesia is considered
safer than general anesthesia.
- You may have trouble urinating.
- The wound may scar and leave a smaller opening in the
rectum, making it difficult to pass stools.
- The remaining hemorrhoids may become inflamed.
- The hemorrhoids could recur.
- There is a risk of infection or bleeding.
You should ask your doctor how these risks apply to you.
When should I call the doctor?
Call the doctor immediately if:
- You develop substantial bleeding.
- You cannot urinate.
- You develop a fever.
- You cannot pass bowel movements.
Call the doctor during office hours if:
- You have questions about the procedure or its results.
- You want to make an appointment for a follow-up office
visit.
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