Hemorrhoids Treatment
Surgical Procedures for
Hemorrhoids
For most of patients with hemorrhoids, non-surgical procedures have proven
quite effective and the need to go under the knife becomes unnecessary.
If treated early with a non-operative treatment method, it is estimated
that 10% of all patients didn’t need surgery. But for cases of
hemorrhoids that requires surgery, there are procedures that are available.
1) Dilation
To weaken the anal sphincter, the anal canal is stretched through forceful dilation. The rationale for this is the belief that increased sphincter pressure causes hemorrhoids. Dilation, as a surgical procedure is rarely used though because it damages the sphincter that renders the patient incontinent or having no power to control bowel movement.
2) Doppler ligation
Recently, doctors are able to pinpoint the specific artery that fills the hemorrhoidal vessels. This is done with the use of a special, illuminated anoscope. It is fitted with a Doppler probe that measures the flow of blood. By tying off or ligating the artery, the hemorrhoid is shrunked. This method is quite expensive though and almost has no advantage over rubber band ligation.
3) Sphincterotomy
To decrease the sphincter pressure inside the anal canal, the internal portion of the sphincter is partially cut. The disadvantage is the resulting incontinence which is why this method is not often recommended if other treatments is available.
4) Hemorrhoidectomy
This surgical procedure is recommended for patients suffering from third- (protruding hemorrhoids) or fourth-degree (protruding hemorrhoids resulting to gangrene) hemorrhoids. The hemorrhoids are surgically removed. During this procedure, the external and internal hemorrhoids are cut out and then the wounds are sutured or stitched together (closed technique) or left open or what is referred to as open technique.
These two techniques have similar results. A protoplasty is often times done to extend the removal of tissues located above the anal canal so that prolapsing anal lining is also removed.
A major problem with hemorrhoidectomy is post-surgical pain. Potent pain drugs or narcotics are often required. In addition, non-steroidal anti-inflammatory medications are used to enhance pain relief after the operation.
Such drugs are ketorolac (Toradol), valdecoxib (Bextra) and celecoxib (Celebrex). (Please refer to new press releases of the FDA for the development of pending drugs). After the operation though, the patients are advised not to return to work for 2 to 4 weeks.
There are also complications that may arise after undergoing hemorrhoidectomy. There is the urinary retention or the difficulty in urinating that is the usual complaint of about 5& of patients. Urinary retention is often temporary but catheterization can be done to relieve the patient.
This is done by inserting a tube to empty the bladder. For a smaller fraction of patients, about 1% to 2%, hemorrhoidectomy results to delayed bleeding after 1 or 2 weeks. The anus may also narrow from scarring, formation of tissues and infection but this only occur in 1% of patients who have undergone hemorrhoidectomy. And unless the anal sphincter is damaged during the procedure, incontinence rarely happens.
Hemroids
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