Hemorrhoidectomy Surgery Offers Lasting Relief for Severe Hemorrhoids
When hemorrhoids become severe, recurrent, or resistant to conservative care, surgical intervention may be the most effective long-term solution. Hemorrhoidectomy is a definitive procedure designed to remove advanced or complicated hemorrhoids entirely, offering lasting relief for patients who have exhausted other treatment options.
This procedure is commonly recommended for large external hemorrhoids, advanced internal hemorrhoids, or mixed cases that significantly interfere with daily comfort. Within the broader scope of hemorrhoids management, hemorrhoidectomy stands out as the most durable—but also the most invasive—treatment option.
What Is a Hemorrhoidectomy?
A hemorrhoidectomy is a surgical procedure that involves the complete removal of enlarged hemorrhoidal tissue. Unlike minimally invasive techniques that shrink or cut off blood supply, this surgery physically excises the hemorrhoids from the anal canal or external area.
It belongs to the medical treatments for hemorrhoids cluster and is generally reserved for cases where less invasive therapies have failed or are unlikely to succeed.
Conditions Commonly Treated with Hemorrhoidectomy
Doctors may recommend hemorrhoidectomy for patients experiencing:
- Grade 3 or grade 4 internal hemorrhoids
- Large external hemorrhoids causing persistent pain
- Recurrent thrombosed hemorrhoids
- Chronic bleeding or prolapse unresponsive to other treatments
In many of these cases, procedures such as rubber band ligation or infrared coagulation may have already been attempted without lasting results.
Types of Hemorrhoidectomy Procedures
There are several surgical techniques used for hemorrhoidectomy. The choice depends on the type, size, and location of the hemorrhoids, as well as the surgeon’s expertise.
Conventional (Excisional) Hemorrhoidectomy
This is the most widely used method. The surgeon removes hemorrhoidal tissue using a scalpel, scissors, or electrocautery device. The wound may be left open or closed with sutures depending on circumstances.
Closed vs Open Hemorrhoidectomy
In a closed hemorrhoidectomy, the surgical site is sutured, while an open hemorrhoidectomy leaves the wound open to heal naturally. Both methods are effective, though healing time may vary.
Stapled Hemorrhoidectomy Alternative
In select cases involving internal prolapse, doctors may suggest stapled hemorrhoidopexy, which repositions tissue rather than removing it entirely. However, this option is not suitable for all patients.
What to Expect Before the Procedure
Before surgery, patients undergo a thorough medical evaluation. This may include a physical exam, review of symptoms, and sometimes imaging or endoscopic evaluation if bleeding is severe.
Your doctor may advise stopping certain medications, especially blood thinners, and following bowel preparation instructions. Understanding the nature of your hemorrhoid type helps determine the most appropriate surgical plan.
The Hemorrhoidectomy Procedure: Step by Step
Hemorrhoidectomy is typically performed under general, spinal, or local anesthesia with sedation. The surgery itself often takes less than an hour.
During the procedure, the surgeon carefully removes the problematic hemorrhoidal tissue while preserving surrounding muscles to maintain normal bowel control.
Most hemorrhoidectomies are performed on an outpatient basis, allowing patients to return home the same day, though some may require short hospital observation.
Recovery and Healing After Hemorrhoidectomy
Recovery is the most challenging aspect of hemorrhoidectomy. Pain, swelling, and temporary discomfort during bowel movements are common in the first one to two weeks.
Pain Management
Doctors may recommend prescription or over-the-counter pain relievers, warm sitz baths, and stool softeners. Many patients also benefit from lifestyle strategies covered under lifestyle adjustments for hemorrhoid relief.
Healing Timeline
Initial healing usually occurs within two to three weeks, while complete recovery can take up to six weeks. Most patients gradually resume normal activities during this period.
Benefits and Effectiveness of Hemorrhoidectomy
The primary advantage of hemorrhoidectomy is its long-term effectiveness. Compared to minimally invasive therapies, it offers the lowest recurrence rates.
According to clinical guidance from the Cleveland Clinic, hemorrhoidectomy is considered the gold standard for treating severe hemorrhoids when other options fail.
Patients often report permanent relief from symptoms such as bleeding, prolapse, and intense pain once healing is complete.
Potential Risks and Complications
As with any surgery, hemorrhoidectomy carries potential risks. While complications are uncommon when performed by an experienced surgeon, they may include:
- Temporary difficulty urinating
- Infection or delayed wound healing
- Bleeding
- Rarely, anal strictures or incontinence
Prompt follow-up care and adherence to recovery instructions significantly reduce these risks. Awareness of possible hemorrhoid-related complications helps patients recognize warning signs early.
Hemorrhoidectomy vs Other Hemorrhoid Treatments
For mild to moderate hemorrhoids, conservative options such as dietary changes, topical creams, or minimally invasive procedures may suffice. Surgeries like hemorrhoidectomy are typically reserved for advanced cases.
Compared with sclerotherapy or banding, hemorrhoidectomy has a longer recovery but superior durability. This trade-off is often worthwhile for patients seeking definitive resolution.
Who Is a Good Candidate for Hemorrhoidectomy?
You may be a good candidate if you experience chronic pain, bleeding, or prolapse that interferes with daily life and has not improved with other treatments.
Patients with complex or mixed hemorrhoids often benefit the most, especially when lifestyle modifications and medications no longer provide relief.
Final Thoughts on Hemorrhoidectomy
Hemorrhoidectomy is a powerful and effective surgical solution for severe hemorrhoids. While recovery requires patience, the long-term benefits often outweigh the temporary discomfort.
Discussing your individual condition with a qualified healthcare provider is essential to determine whether hemorrhoidectomy is appropriate. When used at the right time, this procedure can restore comfort, confidence, and quality of life for patients struggling with advanced hemorrhoidal disease.
For medically reviewed information on surgical hemorrhoid treatments, visit the Cleveland Clinic’s official health resources.