Inspection: A surgical tool called a retractor is inserted into the anus and rectum to allow the surgeon to

inspect the internal hemorrhoid.

Access: The hemorrhoid is grasped with a small clamp and pulled away from the anal sphincter muscles.

Excision: An elliptical- or diamond-shaped incision is made in the rectal tissue around the hemorrhoid.
The hemorrhoid is cut away from the sphincter muscles. The swollen vein inside of it is tied off with a
suture to prevent bleeding. The hemorrhoid is then removed. This step may be repeated if more than
one hemorrhoid is present.

Closure: The skin edges may be left open or closed with an absorbable suture. The anal area is covered
with a dressing

After the Surgery

A nurse will monitor your vital signs in the recovery room as you slowly wake up from general
anesthesia or the sedative.

Since urinary retention is a potential complication of hemorrhoid surgery, you may be asked to urinate
before being approved to go home (if a same-day surgery).14

If you are staying in the hospital, you will be wheeled on a gurney to your hospital room.

Recovery

Recovery can take anywhere from one to six weeks, depending on the type and extent of your
surgery.15

As you recover at home or in the hospital, expect to experience pain and a sensation of anal fullness or
tightness for the first week or so.2

To ease your pain, your surgeon will advise the following:

Take your pain medication as prescribed. This often includes an NSAID like Motrin (ibuprofen). An opioid
may be given for more significant pain (although, opioids can cause constipation).
Apply an ice pack, a bag of frozen peas, or a zipper bag filled with ice wrapped in a thin towel to your
bottom (ask your surgeon for specific instructions on the timeline for icing).

Take sitz baths for 15 to 20 minutes, three to four times per day.

Drink at least eight glasses of water a day and take stool softeners as advised. Both can help you avoid
constipation and worsening of your pain.

You can expect to have a bowel movement by the third day after your surgery.16

It's important to follow up with your surgeon as advised. During these appointments, your surgeon will
check your wound site, monitor for complications, access your pain, and remove any sutures (if
applicable).

Wound Care

Mild bleeding and a yellow-red discharge from the anal area are common after surgery.10 Both may
increase with bowel movements and activity.

Your surgeon will advise you to wear pads to monitor the drainage and to avoid soiling your underwear
and pants.

You may also have a gauze dressing over your anal wound or some sort of packing in your anal area. Talk
to your surgeon about when to remove this and how to change or replace it (if applicable and
necessary).

Check with your surgeon, but you can probably shower the day after surgery. That said, you will want to
avoid submerging your wound in a soapy bath for one week (sitz baths are OK).

If you have any stitches, they will dissolve around 10 to 14 days after surgery or be removed at one of
your follow-up appointments.10

Physical Activity
You will have specific activity guidelines to follow after surgery, such as:17

You can begin moving around the day after surgery and should be able to resume simple, light
activities/chores. Use pain as your guide.

You can drive when you are off all prescription pain medication.

Avoid sitting for long periods of time. Use a soft cushion or pillow when doing so.

Avoid heavy lifting or straining with bowel movements for at least five to seven days.

When to Call Your Surgeon