Results vs Risks ofthe procedure

Results vary depending on the severity of the haemorrhoids and the type of procedure you have

Less invasive procedures

Rubber band ligation: Relatively safe and painless with a low risk of complications or recurrence, the main complication being infection at the anus which rarely spreads generally. No anaesthetic is needed. Can be done in the doctor’s office.

Injections: Good for treating small haemorrhoids. Very little discomfort. No anaesthetic is needed. Can be done in the doctor’s office. Injecting a haemorrhoid in the front wall of the rectum occasionally results in injecting the prostate accidently. There is also some risk of local and general infection.

Coagulation: Infrared coagulation works in 7 out of 10 people. Improvements may not be permanent. Procedure is painful. Laser coagulation is no better than infrared, takes longer and may cause more scarring. Can be done in the doctor’s office. Coagulation is painful and the possible adverse effects include bleeding, infection and a temporary inability to urinate.

Surgical procedures

Haemorroidopexy: Not as effective as haemorrhoidectomy but a shorter procedure with less pain and an earlier return to activities.

Transanal haemorrhoidal dearterialisation (THD): There’s always some post-operative pain, bleeding and short-term pain on defecation. Overall recurrence is 9% but higher for higher-grade haemorrhoids.

Closed haemorrhoidectomy: The most common surgery for haemorrhoids. Effective in 95% of cases but recovery is painful. Potential complications include pain, delayed bleeding, urinary retention/urinary tract infection, faecal impaction, and very rarely, infection, wound breakdown, faecal incontinence and anal stricture.

Open haemorrhoidectomy: Effective in 95% of cases and the preferred technique of many surgeons. Recovery is painful. Complications following open haemorrhoidectomy are similar to those that occur after closed haemorrhoidectomy.

Risks and complications

As with any medical procedure there are some potential risks. The chance of complications depends on the exact type of procedure you’re having and other factors including your general health.

Risks of haemorrhoid surgery depend on the procedure and may include:

• constipation for a few days after the operation
• pain on defecation
• faecal impaction
• difficulty passing urine (you may need a urinary catheter to empty your bladder)
• bleeding
• infection
• wound breakdown
• haematoma (blood clot)
• skin tags
• anal fissures
• in women: fistula (passage) between the anus and the vagina
• damage to the anus or rectum
• penile damage to the patient’s partner if they encounter staples during anal sex
• feeling a constant need to defecate
• faecal incontinence
• scar tissue causing your anus to become tighter, which can make defecation difficult
• chronic pain.

Ask your surgeon about the results and risks associated with your procedure. Also ask about their own rates of patient satisfaction and the rate of complications following the procedures they’ve performed.