Hemorrhoidectomy surgery in Iran used to remove internal or external hemorrhoids that are extensive or severe. Surgical hemorrhoidectomy is the most effective treatment for hemorrhoids, though it is associated with the greatest rate of complications.
Hemorrhoidectomy surgery in Iran, also known as piles is an enlarged, swollen aggregation of inflamed veins along with smooth muscle and connective tissue in the rectum and anus that can cause discomfort and bleeding. Sometimes, the hemorrhoid may protrude outside the anus (external hemorrhoids) or remain within the rectum (internal hemorrhoids).
Symptomatic hemorrhoids that affects the quality of life is an indication for intervention. The symptoms include pain, bleeding and difficulty maintaining anal hygiene. The main purpose of a hemorrhoidectomy surgery in iran is to relieve the symptoms such as pain and bleeding in cases that have not responded adequately to conservative treatment.
Hemorrhoidectomy (Hemorrhoids) is usually managed by diet and medicines, since this is not a life-threatening condition. Surgery is generally recommended only as a last resort, when all else fails. Hemorrhoidectomy surgery in iran is particularly useful for treating large internal hemorrhoids, which can cause complications, such as mucus discharge or fecal leakage as the internal hemorrhoids prolapse through the anal canal. The accompanying irritation of the perianal skin can result in severe itching (pruritus). External hemorrhoids can also be a cause of great discomfort.\
Hemorrhoids first comes to the notice of the doctor when a patient complains of bleeding following a bowel movement. The doctor performs a digital examination of the rectum in order to rule out other possible causes. Following the digital examination, the rectum and lower part of the large intestine are observed with an anoscope, proctoscope or sigmoidoscope to check for internal hemorrhoids. The doctor may recommend a barium enema only if he suspects colorectal cancer. Otherwise, imaging is not routinely done for hemorrhoids. In certain instances, a stool guaiac test or guaiac fecal occult blood test (gFOBT) may be ordered to detect blood in the stool that is not visible to the naked eye.
The doctor should know about any medications that the patient may be taking. Some medicines that may need to be stopped several days before the surgery include the following:
The patient is advised to stop smoking for two weeks prior to surgery as smoking can impede the healing process.
Routine blood and urine tests are carried out to determine the health status of the patient and rule out any underlying disease.
A chest x-ray and electrocardiogram (ECG) will be performed to rule out any heart or lung disease.
The patient is evaluated before surgery by the cardiologist and anesthetist and proclaimed fit for surgery.
The patient is instructed to get admitted to the hospital on the evening prior to the operation for undergoing certain procedures and for medications.
The patient will be asked not to eat or drink 6 to 12 hours prior to the surgery. These instructions should be strictly adhered to.
Saline enemas are also given on the morning of surgery to wash and cleanse the rectum and lower part of the large intestine of any fecal matter. This will enable the surgeon to get a clear view of the operating area.
The patient is advised to take a bath as usual and given a sterile surgical gown to wear before being taken to the theater.
There are several different types of hemorrhoidectomy(hemorrhoid surgery), as described below:
Rubber band ligation
This is a procedure for treating bleeding or prolapsing internal hemorrhoids. It involves placing a rubber band around the base of a hemorrhoid. This will restrict its blood supply, eventually causing the hemorrhoid to fall off.
Coagulation can treat bleeding internal hemorrhoids that are not protruding. A doctor will use an electric current or infrared light to create scar tissue on the hemorrhoid. This tissue will restrict the blood supply to the hemorrhoid, again, causing it to fall off.
This procedure involves a doctor injecting a chemical solution into an internal hemorrhoid. The solution helps to relieve pain by making nerve endings numb around the area. It also causes scar tissue to form, and the hemorrhoid to fall off.
This procedure aims to remove the hemorrhoid. A surgeon performs the procedure in a hospital where the patient receives either a spinal block or a local anesthetic.
The surgeon will open the anus and gently cut out the hemorrhoids. They can make the cut using a variety of surgical instruments, such as surgical scissors or a laser. There is no difference in discomfort between these devices.
After removing the hemorrhoids, the surgeon will seal the wounds, leave the wounds open, or use a combination of both methods.
The reason for leaving a wound open is typically either that the wound is difficult to close due to its location or that other health conditions are present.
After the hemorrhoidectomy surgery in iran is completed, the patient is transferred to the recovery room.
Recovery period can be short if local anesthesia is used, while substantially longer if GA is used. Spinal anesthesia usually takes a few hours to wear off. The patient lies on the back horizontally for at least an hour following surgery to prevent anesthesia induced headache, which can be intense and take a long time to subside.
The intravenous channel remains connected until the patient can take clear fluids by mouth as well as tolerate it. Since GA can cause nausea, oral intake of fluids can be delayed.
Once the patient can tolerate oral fluids, the diet can be changed to solid food.
Before discharge, the patient must regain full sensation of the lower part of the body. Moreover, the ability to urinate without catheter support is also a prerequisite for discharge.
Hemorrhoidectomies have a high success rate. Most patients have a satisfactory recovery following surgery, without any complications or recurrence. However, even after a successful surgery, there is a 5% chance of recurrence. Complications are usually rare with hemorrhoidectomy, but nevertheless, can occur. One of the most painful complications of internal or external hemorrhoids is thrombosis. Other complications may include the following:
Anal fistula or fissure
Excessive fluid discharge from the rectum
Fever of 38°C or higher
Inability to urinate or have bowel movements
Intense pain if bowel movements occur
Redness and swelling in the rectal area
Stenosis (narrowing) of the anus
Recurrence of the hemorrhoid
Risks & Complications of Hemorrhoidectomy
Patients can experience pain and discomfort during the first week following surgery, for which painkillers are usually prescribed.
An antibiotic such as metronidazole may be prescribed to prevent infections.
Minor to moderate bleeding can occur during defecation for the first two weeks following surgery. This is normal and usually subsides once the rectum has healed properly. If a pack was inserted in the rectum after surgery, it can be removed within a day after discharge.
An ice pack may be used for reducing the swelling and pain in the anal region. A mild anesthetic ointment can be applied before and after bowel movements to relieve the pain. Sitting upright is usually a major problem following surgery.
For maintaining a comfortable sitting posture, a special type of doughnut shaped cushion may be used. Soaking in a warm sitz bath can be comforting and relaxing, and can provide relief from pain and muscle spasms.
Avoiding constipation is crucial during convalescence. The doctor usually prescribes stool softeners and laxatives to prevent constipation.
The patients are advised not to lift heavy weights during the recovery period. Complete recovery occurs between 6 weeks to 2 months. However, the patient can generally resume work within 2 weeks.