Our Summary

This research paper is a review of past studies on two common treatments for hemorrhoids: stapled hemorrhoidopexy and excisional hemorrhoidectomy. The researchers were particularly interested in how often patients experienced incontinence (loss of bowel control) after these procedures. They looked at data from 139 studies, which together included over 30,000 patients.

Their findings showed that roughly 5% of patients experienced incontinence in the first three months after surgery in the more carefully controlled studies, and around 1% in the less strictly controlled studies. For patients who had the surgery more than three months ago, about 2.5% from the more controlled studies and 1.4% from the less controlled studies experienced incontinence.

Importantly, they found no significant difference in the risk of incontinence between the two procedures. But, they noticed that the methods and definitions used to assess incontinence varied greatly between studies, which could affect these results. They suggest that future research should standardize how incontinence is measured, and should also assess patients’ bowel control before the surgery, to get a more accurate picture of the risks associated with these procedures.

FAQs

  1. What are the two common treatments for hemorrhoids that were reviewed in this research paper?
  2. What percentage of patients experienced incontinence within the first three months after the surgery according to the research?
  3. Did the research find a difference in the risk of incontinence between the two procedures for treating hemorrhoids?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hemorrhoidectomy is to carefully follow post-operative instructions, including proper wound care and pain management. It is also important to eat a high-fiber diet, stay hydrated, and avoid straining during bowel movements to promote healing and prevent complications. Additionally, patients should communicate any concerns or changes in symptoms to their healthcare provider to ensure proper healing and recovery.

Suitable For

Hemorrhoidectomy is typically recommended for patients with severe or persistent symptoms of hemorrhoids, such as:

  • Bleeding during bowel movements
  • Pain and discomfort
  • Prolapsed hemorrhoids (hemorrhoids that protrude from the anus)
  • Chronic or recurrent hemorrhoids that do not respond to other treatments

Patients who have tried conservative treatments such as dietary changes, over-the-counter medications, and other non-surgical interventions without success may also be candidates for hemorrhoidectomy. Additionally, patients with large or multiple hemorrhoids may benefit from surgical removal.

It is important for patients considering hemorrhoidectomy to discuss their symptoms and treatment options with a healthcare provider, who can provide personalized recommendations based on their specific condition and medical history.

Timeline

Before hemorrhoidectomy:

  1. Patient experiences symptoms of hemorrhoids such as pain, itching, bleeding, and swelling in the anal area.
  2. Patient may try conservative treatments such as dietary changes, over-the-counter medications, and topical creams to alleviate symptoms.
  3. If symptoms persist or worsen, patient may be referred to a surgeon for evaluation.
  4. Surgeon determines that hemorrhoidectomy is the most appropriate treatment option for the patient.

After hemorrhoidectomy:

  1. Patient undergoes hemorrhoidectomy surgery, which can be performed using different techniques such as stapled hemorrhoidopexy or excisional hemorrhoidectomy.
  2. Patient may experience some pain, discomfort, and bleeding in the immediate post-operative period.
  3. Patient is advised to follow post-operative care instructions provided by the surgeon, which may include pain management, dietary modifications, and hygiene practices.
  4. Patient gradually recovers over the following weeks, with symptoms improving and healing of the surgical site.
  5. Patient follows up with the surgeon for post-operative appointments to monitor healing and address any concerns.
  6. Patient returns to normal activities and experiences long-term relief from hemorrhoid symptoms.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a hemorrhoidectomy?
  2. How long is the recovery period after a hemorrhoidectomy?
  3. What can I expect in terms of pain and discomfort after the surgery?
  4. Will I need to modify my diet or lifestyle after a hemorrhoidectomy?
  5. How soon can I return to work or normal activities after the procedure?
  6. Are there any alternative treatments or less invasive options for my hemorrhoids?
  7. How experienced are you in performing hemorrhoidectomies?
  8. Can you provide me with information on your success rates and patient outcomes for this procedure?
  9. Will I need to follow up with you after the surgery, and if so, how often?
  10. How likely am I to experience incontinence or other complications after a hemorrhoidectomy, based on my individual health and medical history?

Reference

Authors: Jin JZ, Men V, Bahl P, Penneru H, Yang R, Shah N, Hill AG. Journal: Surgery. 2025 Apr;180:109139. doi: 10.1016/j.surg.2024.109139. Epub 2025 Jan 23. PMID: 39854786