Hemorrhoids Operations, Complications and Choices

When the relief of hemorrhoids just isn’t enough: INJECTION of hemorrhoids, CAUTERIZATION of hemorrhoids, INFRARED and LASER Coagulation of hemorrhoids, hemorrhoid BANDING, hemorrhoid CRYOTHERPAY and hemorrhoid STAPLING can be considered. Hemorrhoid Artery Ligation Surgery is an option mainly available in Asia, but is now spreading slowly round the world. Hemorrhoidectomy is the mother of all hemorrhoids surgery – not to be taken lightly, as the pain and discomfort following it is quite severe. If you find the idea of hemorrhoids surgery unpleasant, then you can learn how to treat hemorrhoids at home successfully, even very big hemorrhoids.

The above video shows the latest technique that is taking off as a replacement for the dreaded hemorrhoidectomy – there is no cut and slice, the blood vessel is tied off and the internal hemorrhoids are pulled up and stitched back up inside.

Many surgeons and doctors can perform hemorrhoid operations of one sort or another, with the more serious operations most likely going to surgeons of course. You may have heard of Hemorrhoid Relief Centers (HRC), which are organisations mostly focused on performing hemorrhoid operations. You may also be interested in learning about specialist hemorrhoid doctors, if surgery is looking like your preferred choice of treatment.

Hemorrhoid surgery has NO guarantees

No hemorrhoid surgery can guarantee you wont have the hemorrhoids coming back again. Hemorhoids can and do come back- for 10% to ?% of people having hemorrhoid surgery, hemorrhoids will return in the first 12 months. This is partly because hemorrhoids are often a life style factor involving poor diet, little exercise, too much alcohol, too much coffee, not enough water and or anal sex. The success rate for hemorrhoid banding and similar type procedures are NOT well known and some webmasters appear to be overestimating the failure rate – perhaps to sell you something worth more to them than the truth is?

Friendly face in the surgery

** Hemorrhoids – Hemorrhoid Surgeries covered THIS PAGE:

1.. Determining which hemorrhoid surgery operation you need.

There is a way surgeons and doctors use to determine what type of surgery to use on a person’s hemorrhoids. With each of the hemorrhoid surgical treatments below, I’ve also included a simple, yet reasonably accurate way of determining the particular hemorrhoid surgery’s suitability for you.

A simple rule to remember, if it’s external hemorrhoids you’ve got, then hemorrhoidectomy is about the only hemorrhoid surgery you can use.

What happens if you choose a lower level of surgery for your hemorrhoids than what appears indicated? What happens is the hemorrhoid surgery will then often fail to achieve the desired results.

For example, if you need the cut and remove hemorrhoid surgery, but you opt for the hemorrhoid surgery of banding ligation, the surgeon may agree for non-medical reasons, like, “I cant take that much time to recover”. The surgeon will try his best, he may even double band the hemorrhoids, but chances are, the hemorrhoid surgery wont work – I know from personal experience as well as discussions with my surgeon and readings that I’ve undertaken – the hemorrhoids may stop protruding, but they frequently don’t die. If you are lucky after the operation and the hemorrhoids don’t protrude and provided you don’t strain, the hemorrhoids may not bother you or grow bigger.

One effect of choosing the lower level hemorrhoid surgery I experienced, was a thrombosed hemorrhoid within days of the hemorrhoid double banding. However, I’m still happy with my less than perfect result and, for me, the lower level hemorrhoid surgery was a good option to the hemorrhoidectomy.

2.. Sclerotherapy Surgery for Hemorrhoids – Dealing with hemorrhoids through a needle and injections.

If hemorrhoids are present, but are not yet protruding out of the anus, there is a good chance they are tiny hemorrhoids which can be treated in surgery by a simple injection into each hemorrhoid. The surgical procedure you follow is very similar to banding, except instead of getting a band they inject. See “The Banding Hemorrhoid Surgery” for more detailed information of the procedure itself.

The injection surgery for hemorrhoids is called “Sclerotherapy”.Sclerotherapy works by injecting a chemical into or near the hemorrhoid that interferes with the vein enlargement and tissue irritation that causes hemorrhoids.

If phenol is the chemical injected, then the aim is to control the hemorrhoid’s bleeding.

If the solution injected into the hemorrhoid is a salt one, the hemorrhoid will normally shrink in size.

While this hemorrhoids surgery is not preferable for the needle-phobic, it is the least invasive method of dealing with small hemorrhoids that cannot be treated by latex band ligation.

However, while this hemorrhoids surgery is performed in a doctor’s office, it is not the most commonly used hemorrhoid treatment and so your doctor may not have performed it before.

No medical procedure is without risks, and sclerotherapy can cause a quite painful burning sensation if the treated hemorrhoid is too near the sensitive nerve band, some people are allergic to the chemical used, and this hemorrhoid surgery carries a higher chance of recurrence.

This hemorrhoids surgery is generally only used on either very, very small hemorrhoids or on people who would not bear a more invasive procedure well.

The Mayo Clinic (Year 2010) has stated that this type of hemorrhoid surgery is less successful than hemorrhoid banding.

3.. Hemorrhoid Cauterization is another surgical option

Hemorrhoid surgery using cauterization, involves burning the hemorrhoids with an electrically heated wire.  Used primarily on tiny hemorrhoids, but instead of injecting, they cauterize.


4.. Infrared Coagulation and Laser Coagulation Surgeries for Hemorrhoids

Hemorrhoids that don’t show, or which retreat after showing themselves, may be treated with Infrared Coagulation Surgeryor Laser Coagulation Surgery. Not something I personally was given an option with, with my hemorrhoids. Reading other hemorrhoid sufferers experiences, I gather this hemorrhoid surgery can involve several treatments and aims at stopping the blood flow to the hemorrhoids by burning the blood veins supplying them.

According to the Mayo Clinic (Year 2010), both these types of hemorrhoid surgery have a lower success rate than the rubber band ligation.

5.. The Banding Hemorrhoid Surgery

aka Rubber Band Ligation Hemorrhoid Surgery

The simplest hemorrhoids surgery appears to be latex band ligation, which can sound a little strange but does work.

This hemorrhoids surgery basically works by putting a very strong rubber band around the internal or prolapsed hemorrhoid, which cuts off the circulation to the mass. Within a few days, the hemorrhoid will atrophy and fall off.

It can be a little frightening to consider cutting off circulation to an area of yourself, but when performed by a doctor this hemorrhoids surgery is one of the safest, simplest and most effective internal hemorrhoid surgeries.

Pain can be excessive if the hemorrhoids are too near the nerve band surrounding the anus, so tell your doctor if you are experiencing a lot of pain.

This hemorrhoids surgery is best on medium sized hemorrhoids, as there must be enough tissue mass for the rubber band to surround.

Want to know more about hemorrhoids banding, such as the procedure in detail, just click.

6.. Hemorrhoid Cryotherapy Surgery

Hemorrhoid cryotherapy surgery apparently can be used with hemorrhoids before they reach the point of remaining outside all the time and, for some people, even when the hemorrhoids are showing constantly. The surgery involves the hemorrhoids being frozen, then left to shrivel and die – very similar result to banding hemorrhoids. Discomfort lasts up to a week, or there about’s.

7.. The Stapling Hemorrhoid Surgery

This hemorrhoid surgery has several names: Procedure for Prolapse and Hemorrhoids (PPH), or Hemorrhoidopexy, or Stapling Hemorrhoidectomy

According to Dr. Gary H. Hoffman, 2003, this hemorrhoid surgery is for internal hemorrhoids that have prolapsed – that is stage 3 and 4 hemorrhoids as well as some stage 2 – it is therefore an alternative surgery to hemorrhoidectomy. He also provides the following hemorrhoid information to the public: To be sure this hemorrhoid surgery will be effective, it is best that the surgeon be properly trained in this specialized hemorrhoid surgery. [Although it wasn’t offered as an option for me, this hemorrhoid stapling surgery would have been my first choice.]

He also goes on to state that this surgery for hemorrhoids, works by repositioning the hemorrhoids and surrounding tissue to where they started from and then the surgeon cuts some of the excess hemorrhoid tissue away – the excess hemorrhoid tissue does not contain nerve fibres, so this hemorrhoid surgery does not cause much pain.

Doing this hemorrhoid surgery properly results in reduced blood flow to the troublesome hemorrhoids, which results in the hemorrhoids dwindling in size over the next few weeks. This hemorrhoid surgery also reduces the recurrence of hemorrhoids. Patients normally return to work very quickly.

However, more recent research on this hemorrhoid surgery now suggests that although there is less risk and pain involved in having a hemorrhoidopexy, around 8.5% were found to have hemorrhoids return. Shiva Jayaraman Colquhoun, M.D., 2006. While the Mayo clinic (Year 2010) reports this hemorrhoid surgery as less successful than hemorrhoidectomy in getting rid of hemorrhoids and also reports that stapling hemorrhoid surgery may [in rare cases] cause a rectal prolapse ( part of the rectum prolpases out through the anus ).

8.. Hemorrhoid Artery Ligation Surgery aka Transanal Haemorrhoidal Dearterialisation

This surgery is also an alternative technique to the traditional hemorrhoidectomy, as well as a suitable replacement for all hemorrhoid surgeries listed above.  Using a special procedure involving doppler / ultrasound, the surgeon identifies which arteries are providing blood to the hemorrhoids and then sutures the blood artery closed just above them.  Result of this hemorrhoid surgery appears to be quite effective, with about 93% of patients remaining hemorrhoid free for the following two years. However, pdf download from nice.org.uk places the failure rate at around 10% after 12 months post surgery.

The Ultrasound Guided Hemorrhoid Artery Ligation surgery, also known as Doppler Guided Hemorrhoid Artery Ligation, was invented in 1995 by Dr. K. Morinaga, a Japanese surgeon.  You may find it abbreviated to UGHAL or DGHAL.

This hemorrhoid surgery took off in Asia only a few years back, but has spread to the UK, Germany and Italy where it is becoming more and more routine and is reffered to as “transanal hemorrhoidal dearterialisation” (THD).

The hemorrhoid surgery atomic bomb:

9.. Hemorrhoidectomy

See also our other page: Hemorrhoidectomy or Hemorhoidectomy for internal hemorrhoids and Hemorrhoidectomy for external hemorrhoids, for a much more indepth treatment of this surgery.

This hemorrhoids surgery is the medical professions equivalent of the A-Bomb.  It works by the surgical removal of not only the hemorrhoids, but of the tissue the hemorrhoids come from.  As this hemorrhoids surgery is the most invasive and damaging of the lot of them, it’s side effects are not to be ignored and it has the longest of the recovery times, spanning several weeks to several months according to the Cedars-Sinai Medical Center (Year: 2003).

The biggest of the short term side effects is excruciating pain for a week or more, as the area is cut out, but not normally stitched back together and the sensitive nerve band around the anus rim can be damaged as well.

The long term side effects of this hemorrhoids surgery can be life long, such as bowel incontinence.  Such side effects are, however, rare – but that’s little comfort if you end up with them. See our page on hemorrhoidectomy recovery for more information.

Having said all that, it appears the best hemorrhoids surgery for getting rid of hemorrhoids permanently.  Though I have to wonder, if it’s successful because of the surgery or because people who have had the surgery do everything they can to keep the hemorrhoids away to avoid having the surgery again!

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