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Is stapled hemorrhoidectomy less painful?

Prof Suneet Sood
Consultant Surgeon,
Malaysia

Q: I have very large haemorrhoids which need surgery. One of them has a small polyp and is not cancerous. I underwent endoscopy, then a biopsy and lastly a colonoscopy. I am extremely scared of classical surgery. My surgeon told me he will do less painful stapling surgery. Then suddenly he left the country referring me to another surgeon. The second surgeon says he will do the classical surgery and stapling is of no use since haemorrhoids will recur soon. I am puzzled and don't know what is right for me. I am not getting constipated constantly, although it happened time and again. I mostly get soft stools. This started to bother me since my last pregnancy 2.5 years ago. Doctor says I have a cut two. This causes me pain time to time. About 2 inches of flesh comes out every time when stools pass and I have to push it back. Do I need surgery? Is it worth going through severe pain?

A:From your description you probably need surgery. It is a good thing that you have had your colonoscopy done. Stapled hemorrhoidectomy is as effective as open (classical) hemorrhoidectomy. Stapled hemorrhoidectomy is also less painful. Therefore I recommend the stapled procedure. Note that if any of your haemorrhoids is very large, or if you truly have a polyp, that particular pile may need to be removed separately. Thus you may end up having a stapled hemorrhoidectomy plus a partial classical procedure. Go to a surgeon who does stapled hemorrhoidectomies and take his advice.