Our Summary

This study was conducted to figure out how often delayed bleeding occurred after patients had a specific type of hemorrhoid surgery (known as a semi-closed hemorrhoidectomy), and to identify any risk factors associated with this kind of bleeding.

The study involved 1,645 patients who had this surgery at Seoul Songdo Hospital between September 2018 and May 2019. Out of these patients, about 1.5% experienced this delayed bleeding, with about half of these cases being “stump bleeding” (from the remaining bit of the hemorrhoid) and the other half being “marginal bleeding” (from the edge of the surgical wound). On average, the bleeding started about 8 days after the surgery.

The study found that being male, having a history of drinking, having more than four hemorrhoids removed, and using laxatives were all factors that increased the risk of experiencing delayed bleeding. Specifically, being male, having more than four hemorrhoids removed, and laxative use were associated with an increased risk of stump bleeding. Drinking and having more than four hemorrhoids removed were associated with an increased risk of marginal bleeding.

FAQs

  1. How often does delayed bleeding occur after a semi-closed hemorrhoidectomy?
  2. What are the risk factors associated with delayed bleeding after a semi-closed hemorrhoidectomy?
  3. What were the common causes of delayed bleeding in the study conducted at Seoul Songdo Hospital?

Doctor’s Tip

Based on these findings, a doctor might advise a patient undergoing a hemorrhoidectomy to limit alcohol consumption, avoid using laxatives, and discuss with their doctor the potential risks associated with removing multiple hemorrhoids during the surgery. It is important for patients to follow their doctor’s post-operative care instructions closely and to promptly report any signs of bleeding or other complications. By being aware of these potential risk factors and taking necessary precautions, patients can help minimize the likelihood of experiencing delayed bleeding after a hemorrhoidectomy.

Suitable For

Therefore, patients who are male, have a history of drinking, have multiple hemorrhoids that need to be removed, and use laxatives may be at a higher risk for experiencing delayed bleeding after a semi-closed hemorrhoidectomy. It is important for healthcare providers to consider these risk factors when recommending this type of surgery to patients.

Timeline

Before the hemorrhoidectomy:

  1. Patient experiences symptoms of hemorrhoids such as pain, itching, bleeding, and discomfort.
  2. Patient consults a doctor who recommends a hemorrhoidectomy as a treatment option.
  3. Patient undergoes pre-operative evaluation and preparation for the surgery.

After the hemorrhoidectomy:

  1. Patient undergoes the surgery, which involves the removal of hemorrhoids.
  2. Patient experiences some pain and discomfort in the immediate post-operative period.
  3. Patient is discharged from the hospital and given instructions for post-operative care, including pain management and wound care.
  4. Patient may experience some bleeding in the days following the surgery, which is normal.
  5. In some cases, delayed bleeding may occur, which can happen around 8 days after the surgery.
  6. Patient may need to follow up with their doctor for monitoring and management of any complications, such as delayed bleeding.
  7. With proper care and follow-up, the patient should experience relief from hemorrhoid symptoms and improved quality of life.

What to Ask Your Doctor

Some questions a patient should ask their doctor about hemorrhoidectomy include:

  1. What type of hemorrhoidectomy procedure will be performed and why is it recommended for my case?
  2. What are the potential risks and complications associated with the surgery, including the risk of delayed bleeding?
  3. What steps can I take to reduce the risk of delayed bleeding after the surgery?
  4. How long is the recovery period expected to be, and what can I do to promote healing and minimize discomfort?
  5. Are there any specific dietary or lifestyle changes I should make before or after the surgery to improve my recovery?
  6. How will pain management be handled during the recovery process?
  7. What signs or symptoms should I watch out for that may indicate a complication, such as delayed bleeding, and when should I seek medical attention?
  8. Are there any alternative treatment options to consider before proceeding with surgery?
  9. How many hemorrhoidectomies have you performed, and what is your experience with managing potential complications such as delayed bleeding?
  10. Can you provide me with more information on the specific risk factors identified in this study that may increase the risk of delayed bleeding after hemorrhoidectomy?

Reference

Authors: Jeong HY, Hwang DY, Cho DH, Lee JK. Journal: Int J Colorectal Dis. 2021 Apr;36(4):857-864. doi: 10.1007/s00384-021-03895-w. Epub 2021 Mar 4. PMID: 33661360