Hemorrhoid Surgery - What Are the Risks & Benefits

Published: 05th May 2009
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Because of the severity or hemorrhoids, or the lack of a suitable treatment from creams, prescriptions, or other remedies for curing hemorrhoids, surgery may be the only course of action for some people.

Here is a list of the 5 most common surgeries/treatments performed by a physician. Three are used for external hemorrhoids and two for internal hemorrhoids.

• Hemorrhoidectomy

• Laser coagulation

• Infrared photocoagulation

Internal Hemorrhoid Surgery

• Injection Sclerotherpy

• Rubber Band Ligation


Surgical removal of hemorrhoids is recommended for third and fourth degree internal hemorrhoids when other treatments are unable to alleviate severe burning, itching, swelling, protrusion and overall pain. A general anesthesia for pain is administered prior to surgery.

Hemorrhoidectomy is appropriate when you have:

• Very large internal hemorrhoids.

• Internal hemorrhoids that still cause symptoms after nonsurgical treatment.

• Large external hemorrhoids that cause significant discomfort and make it difficult to keep the anal area clean.

• Both internal and external hemorrhoids.

• Had other treatments for hemorrhoids (such as rubber band ligation) that have failed.


• May provide better long-term results

• 95% success rate of hemorrhoids reoccurring

• When nothing else works


• Surgery is more costly

• Greater risk of complications

• More painful than other procedures

• Recovery may take longer 2-3 weeks

Laser Surgery for Treatment of Hemorrhoids

This is becoming the preferred laser surgery (versus Laser Coagulation). This process vaporizes or excises the hemorrhoid by a surgeon. The laser beam is infinitely small allowing for precision and accuracy. Generally results in a rapid healing.

Laser Coagulation involves an electric current applied to the hemorrhoid through an electrode probe. The hemorrhoid went through a chemical reaction to stop the flow of blood to the hemorrhoid thus resulting in the shrinking of the swollen tissue.


• Less painful

• Less invasive

• Less expensive

• Faster healing process

• Usually no over night hospital stay - may be performed in doctor's office


• Hemorrhoids may reoccur

Infrared photocoagulation (also called coagulation therapy)

This is procedure is used to treat small and medium sized hemorrhoids. Doctors recommend coagulation therapy in cases where small internal hemorrhoids continue to cause symptoms after home treatment.

It involves a device that creates an intense beam of infrared light. The heat created by the light causes scar tissue, which cuts cutting off the blood supply to the hemorrhoid. The hemorrhoid dies, and a scar forms on the wall of the anal canal. Only one hemorrhoid can be treated at a time. Infrared photocoagulation is done in a doctor's office.


• Small internal hemorrhoids are often successfully treated with coagulation therapy (Large hemorrhoids are more likely to be treated with rubber band ligation)


• Procedure is painful

• Only one hemorrhoid can be treated at a time

• Expensive

Rubber Band Ligation

One of the most common hemorrhoid surgeries is rubber band ligation. A tiny rubber band (diameter about 1/25 of an inch) is fitted onto a special gun-like device. When the trigger is pulled, the rubber band is forced onto the base of the hemorrhoid, thus cutting off the blood flow to the hemorrhoid. The hemorrhoid shrinks and within a week, falls off. The results are a scar in the place of the hemorrhoid. Rubber band ligation works best on first and second degree hemorrhoids.

The procedure is done in a doctor's office. Treatment is limited to 1 to 2 hemorrhoids at a time if done in the doctor's office. Several hemorrhoids may be treated at once if the person has general anesthesia.


• Lease expensive of all surgical procedures

• Repeat treatment for recurring symptoms is rarely needed

• Performed in doctor's office

• Quick Recovery

• Most widely used treatment for internal hemorrhoids


• Painful

• Not all doctors have the experience or equipment to do rubber band ligation


In sclerotherapy, a chemical solution is injected around the blood vessel to shrink the hemorrhoid. This process is used to treat bleeding internal hemorrhoids where by a sclerosing or hardening solution is injected into the base of the hemorrhoids. Sclerotherapy is recommended for smaller hemorrhoids, such as first degree and early second degree hemorrhoids. Doctors recommend injection sclerotherapy in cases where:

• Small hemorrhoids do not improve with home treatment.

• Internal hemorrhoids are too small to treat with rubber band ligation.

• You have persistent bleeding from hemorrhoids.

• You are older than age 70 or are in poor health and would not be a candidate for more invasive surgery.


• Inexpensive

• Multiple hemorrhoids can be treated at the same time

• Fast procedure

• Minor pain and discomfort

• Performed in doctor's office


• Sclerotherapy is not a cure for hemorrhoids

• Hemorrhoids often recur after injection sclerotherapy

Generally surgery is a last resort for most people because of the risks, pain, expense and recovery time. If you are interested in reviewing other methods, please visit Natural Hemorrhoid Treatments.

Resources for the above information: RevolutionHealth.com, SurgeryChannel.com, WebMD.com, HealthWatch.Yahoo.com, eMedTV.com

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