If hemorrhoidal disease is treated at an early stage, surgery can usually be avoided. Many sufferers are ashamed and put off going to the doctor for a long time. Surgical measures are therefore often necessary to get the sometimes severe symptoms under control. Around 50,000 hemorrhoid operations are performed in Germany every year.
You can find more information and qualified doctors for hemorrhoid surgery here.
Doctors divide hemorrhoidal disease into four stages.
In the first and second stages, the enlarged vascular cushions around the rectal mucosa are not visible from the outside. If they are pushed out through the anus, they usually retract on their own after a short time.
In the early stages, the following can help
Haemorrhoids in the third stage of the condition occur
and no longer retract on their own.
Haemorrhoids can be located in the rectum in front of the anus or outside © Henrie | AdobeStock
In the fourth stage, the enlarged haemorrhoids can no longer be pushed back into the bowel with the fingers. In this stage, there is a so-called anal prolapse (prolapse of the mucous membrane of the anal canal through the anus).
Patients in the third and fourth stages often suffer from pronounced symptoms such as
In the advanced stages, hemorrhoid surgery is unavoidable and the only option for healing.
Various painless procedures are available for the removal of enlarged haemorrhoids. The procedure is performed under general or local anesthesia.
Below we describe the most common hemorrhoid surgery procedures.
This classic technique is used particularly frequently. Individual hemorrhoidal nodes are pulled out and excised.
The wound in the anal area remains open with this method. This is why the procedure is also known as an open hemorrhoidectomy (ectomy = removal).
Milligan-Morgan haemorrhoid surgery is particularly suitable for third and fourth stage haemorrhoids.
The Ferguson method is a variation of the Milligan-Morgan procedure. It is particularly popular in the USA. The operation is performed in exactly the same way as the Milligan-Morgan method. However, at the end of the operation, the surgeon closes the wound with a longitudinal suture.
The procedure is therefore also known as a closed hemorrhoidectomy. The advantage of the closed wound is that the pain subsides more quickly after the operation. However, there is a risk of a scarred anal suture.
The Parks method is mainly used for extensive fourth-degree hemorrhoids.
The incision in the anal mucosa has the shape of a "Y". The hemorrhoidal cushions are exposed and removed from under the mucous membrane. Blood vessels are cut off and the edges of the wound are sutured in a T-shape.
Parks haemorrhoid surgery has several advantages:
The procedure is usually used for hemorrhoids in the fourth stage with considerable discomfort. The procedure is very time-consuming and has a plastic character (reconstructive hemorrhoidectomy).
After making a U-shaped incision in the anal skin, a flap of skin is created which is folded outwards. The underlying haemorrhoids are removed and the blood vessels leading to and from them are cut off. The flap of mucous membrane is then folded back and sutured.
Even with this procedure, the patient hardly feels any pain after the operation. The wound heals quickly and no sensitive skin of the anal canal is lost.
The Stapler/Longo method is a relatively new procedure. It is mainly used for third-degree hemorrhoids.
The surgeon does not cut, but rather lifts the hemorrhoids. Using a special instrument, the hemorrhoidal nodes are brought back into their normal anatomical position.
The stapler method can only be used if the anal canal has not yet permanently protruded outwards. As the operation takes place in an area of mucous membrane without pain nerves, there is little or no pain after the procedure.
Overall, the risk of complications after hemorrhoid surgery is very low. With all surgical techniques, there is a risk of more or less severe postoperative bleeding. For this reason, patients usually stay in hospital for three days.
Men may experience discomfort when urinating (urinary retention). In rare cases
Stenoses can also occur very rarely. Stenoses are constrictions. In this case, this refers to narrowing of the anal canal due to the formation of scar tissue. In the first few weeks after the procedure, there is often an increased urge to defecate.
In the period following haemorrhoid surgery, a number of measures help with post-operative healing. Intensive aftercare is particularly important for open wounds.
Thorough and gentle hygiene supports the healing process. The anus should be gently cleaned with lukewarm water after every bowel movement. You should then cover the wound with a cloth or compress.
Zinc ointment protects the skin and promotes the healing of the wound. Synthetic underwear should not be worn to allow air to reach the wound. Underwear made of pure cotton is best, as it is permeable to air and absorbs moisture.
Bowel movements should be kept soft after the operation with the help of fiber-rich food and plenty of fluids. This avoids pain when going to the toilet. Excessively soft stools, on the other hand, contaminate the wound and can cause severe pain.
Patients should never take laxatives during the healing phase.
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