What are hemorrhoids?
Hemorrhoids are swollen veins in the lowest part of the rectum and anus. They are also called piles.
The most accurate explanation for the development of hemorrhoids is that they appear due to the abnormal sliding of the veins at your bottom because of sustained straining during passing stools along with irregular bowel habits.
Hard, bulky stools (as in long-term constipation) promote straining, which is more likely to push the cushions of the blood vessels out of the anus. The straining may also cause congestion or engorgement of the cushions during passing stools, making their displacement more likely.
Because of prolonged strain and pressure, the walls of these blood vessels may stretch so thin that the veins bulge and get irritated, leading to swelling and bleeding.
The symptoms of hemorrhoids include
- Swelling or lump around the anus,
- Burning sensation and
- Sticky discharge from the anus.
The treatment options for hemorrhoids include
- Conservative management (lifestyle modifications, home remedies, and medications),
- Office-based treatments (sclerotherapy, rubber band ligation, and infrared coagulation) and
- Operative treatments (excisional hemorrhoidectomy, stapled hemorrhoidopexy, and hemorrhoid artery ligation (HAL)).
What are the differences between stapled hemorrhoidopexy and hemorrhoidectomy?
The differences are as follows:
- A hemorrhoidectomy is a procedure for the surgical removal (excision) of hemorrhoids.
- Stapled hemorrhoidopexy involves stapling the last section of the large bowel, which reduces the supply of blood to the hemorrhoids and causes them to gradually shrink.
Type of anesthesia
- A hemorrhoidectomy may be performed under local or general anesthesia.
- In stapled hemorrhoidopexy, general anesthesia is usually used, though the procedure may be performed with monitored anesthesia care (MAC) and local anesthesia.
- Hemorrhoidectomy: Pain is usually mild during the initial days after the procedure but is exacerbated by bowel movements.
- Stapled hemorrhoidopexy: Pain is usually most severe in the first 72 hours. Bowel movements do not increase the pain.
In the cases of prolapsed hemorrhoids (hemorrhoids that have slipped down out of the anus)
- Hemorrhoidectomy can treat both prolapsed and non-prolapsed hemorrhoids.
- Stapled hemorrhoidopexy cannot be used to treat prolapsed hemorrhoids.
- Success rate is similar for both the procedures.
- Postoperative complications are similar for both the procedures.
What are the complications of a hemorrhoid surgery?
The complications of a hemorrhoid surgery include
- Urine retention,
- Abscess (a localized collection of pus),
- Fistula formation (an abnormal communication path between the anus and rectum),
- Loss of bowel control and
- Anal stenosis (abnormal narrowing of the anus).
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