Hemorrhoids are painfully common, occurring in 4.4 percent of Americans, most frequently in those between the ages of 45 and 65, Orit Kaidar-Person, M.D. of the Southern Illinois School of Medicine states. Hemorrhoids can cause pain and bleeding if they prolapse, ulcerate or develop clots. Surgery is normally done under general or spinal anesthesia, often as an outpatient procedure. A number of complications can result from surgery to remove hemorrhoids.
Pain
Pain after hemorrhoidectomy can be severe and lasts for 2 to 3 weeks after surgery, Hemorrhoid.net states. Postoperative pain is the main deterrent for patients contemplating surgery for hemorrhoids, the American Society of Colon and Rectal Surgeons states. Anal spasm after surgery contributes to pain.
Urinary Issues
Urinary issues are common after hemorrhoid surgery. Urinary retention, which affects between 2 and 36 percent of patients, according to the ASCRS, can occur from pain, narcotic usage for pain, fluid overload and trauma from the surgery. Urinary tract infection occurs in around 5 percent of patients after hemorrhoid surgery, Hemorrhoid.net reports. A urinary catheter may be temporarily necessary. Giving minimal fluids during surgery helps prevent urinary retention.
Hemorrhage
Bleeding can occur when epinephrine, a vasoconstrictor, is used to constrict blood vessels during surgery and the wound isn't closed. When the epinephrine wears off, the blood vessels relax and the wound bleeds, Thomas Zuber, M.D. of Saginaw Cooperative Hospital states in the April 2002 issue of "American Family Physician." In 1 to 2 percent of patients, delayed hemorrhage occurs 7 to 16 days after surgery, Hemorrhoid.net states. Delayed hemorrhage may require surgery to place one or two extra stitches.
Bowel Issues
Anal leakage commonly occurs in the first few weeks after surgery, but the patient gradually regains control. Constipation and fecal impaction can also occur from narcotic usage and pain. Stool softeners help prevent constipation. After surgery, scar tissue can develop around the anus, resulting in anal stenosis, a narrowing of the anus. Anal stenosis affects up to 6 percent of patients. Anal fissure, a tear in the mucosa, can also occur after surgery. Problems with the anal sphincter occur in up to 12 percent of patients, the ASCRS reports.
Infection
Infections are uncommon after anal surgery; abscesses develop in less than 1 percent of patients, and severe infections are rare.
References
- American Society of Colon and Rectal Surgeons: Hemorrhoids & Fissure-in-Ano
- "American Family Physician": Hemorrhoidectomy for Thrombosed External Hemorrhoids; Thomas Zuber, M.D. April 2002
- Hemorrhoid.net: Surgical Treatment Options for Hemorrhoids
- Southern Illinois University: Hemorrhoidal Disease: A Comprehensive Review; Ori Kaidar-Person, M.D.
