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trike1983 09-25-2017 08:05 PM

Should I Get a Hemorrhoidectomy? You Decide!
Yup. This is now where life finds me, posting on a forum about hemorrhoids. But hey, I figure once a couple doctors and their attractive female residents have looked into your butt, this isn't so bad.

Here's my story, hopefully ya'll can give me your two cents about it, because it's my been experience doctors who have never had hemorrhoids don't tend to give good advice, and surgeons do as surgeons do, and are prone to want to cut into you, given the chance.

34 year old male. No health problems ever aside from the 'ole hemorrhoids. Had 5 internals banded last year with great success (no more bleeding or bulging! yay!), but a few months ago started to notice how the tags the hemorrhoids left behind weren't going away. Went to another colorectal surgeon who explained those things are not tags, they're pieces of external hemorrhoid left behind, and the only way to get rid of them is to snip them off. Hemorrhoidectomy? I said. Doctor nodded her head. Doctor said I can choose not do anything about them, as it's no real problem, but that since I'm a strong healthy man and since there's only a few external hemorrhoids, I should heal up just fine, and be up and about again in two weeks. She seemed to be selling me the operation, so I went with the idea.

Then, two weeks passed, in which I got more and more scared, read more and more message boards, and experienced the doctor not responding to my phone calls (called twice with questions before surgery, and no reply), so I canceled it. Felt good about this decision, but as all you hemorrhoid sufferers know, it's hard not to think about how much these things suck, and here I am again, going back to the same doctor to discuss the surgery, and debating if indeed, I should get it.

I realize this decision is mine, and I'm not here so ya'll will literally make the decision for me, but I would like to hear any input, given my situation.

I don't need this surgery. Mainly these things are like loose flaps of skin, about the size of small grapes that cause no pain, and, at the worst, make hygiene a little more involved. They're prone to swell up now and then, but not anything too uncomfortable, and it's usually resolved within the hour. They're unsightly for sure, but I'm also a large, straight, hairy mammal and don't foresee a lot of situations in which someone will want to be looking into my butt.

At the same time, these will never, ever go away unless they're snipped off. And as many of you dream of, it seems like heaven for me to think of being able to wipe the old rear effortlessly after a BM without feeling these little monsters there. ALWAYS THERE.

I don't particularly fear the pain involved, but I do fear the complications. I realize this is a surgery with high success rates, but this is also an area you absolutely do not want any long-term complications with. Just seeing the words stenosis or fecal leakage freaks me the f*** out. I want to believe this highly qualified surgeon when she says that I'd heal up nicely (the strong healthy mammal that I am), but I also realize this person is a surgeon who is paid to cut people. I want to believe that I'll be happy as can be after two weeks, but I also know it could be worse, much worse. I don't want to mess with a condition that is completely benign and manageable, but man, I can't see myself ever not thinking about how much this sucks, and sucks to clean after BM, and sucks to look it, and sucks to just know about it.

Any words of wisdom from the community? I have days where I don't care and tell myself "suck it up, this is just part of life, this isn't a real problem, and if you're spending time thinking about how your rear doesn't look as nice as it could or complaining about how it's just a little annoying to clean, you don't have actual problems." And then other days it's like, "well, the surgery should go fine, the success rates are high, then you'd likely never have to think about this again." Decisions, decisions.

If you think I sound like a wimpy wuss complaining about something stupid, please tell me. If you think I'm a wimp that just needs to get the surgery to feel better, please tell me. Thanks in advance.

MSNik 09-26-2017 01:32 PM

Re: Should I Get a Hemorrhoidectomy? You Decide!
Have you gone back to the GI doctor who did the banding? My husband and my mother both had banding done, all 3 columns, 2 times each- neither have those "tags' you are talking about.

Its possible they could be banded again? Maybe it is also possible to have the small areas removed without actually going through the entire surgery....

I would start with the GI doc who did this to you before committing yourself to surgery.

Good luck!

louise1300 09-27-2017 07:23 AM

Re: Should I Get a Hemorrhoidectomy? You Decide!
I am having a hemorrhoidectomy soon, but am suffering terribly and have been in extreme pain for a full year. I would never consider this surgery unless I was in terrible pain, and it having a huge effect on my quality of life, because I would not want to risk something happening as a result of the procedure (as you also fear) and making my life even more miserable than it is right now. My surgeon is also of that opinion, and while he does a lot of the procedures in his practise, he also will not perform the surgery unless the patient is really suffering already. Good luck with your decision, but my vote would be no, if I were in your current position.

trike1983 09-27-2017 06:54 PM

Re: Should I Get a Hemorrhoidectomy? You Decide!
Much appreciated, louise1300. I'm sorry for your pain and condition. My life last year was quite terrible until I bit the bullet, called up a surgeon, and had the banded ligation for the internals. Walking to the hospital in the dead of winter alone for this kind of thing is something I'd like to never remember again.

When I went to this different surgeon about the externals (I moved cities and this is the only colorectal surgeon I found in my health plan), I was hoping she'd be very against it, so I could have closed the book on it, but the fact she was so willing to do it and seemed eager to do so threw me a curve. I have no idea if the surgeon is good and my condition so minor that she feels very confident there'd be no issues, or if the surgeon just really wants to cut me. I'll meet with her one more time to go over my concerns and hopefully get a better reading of this person.

Thanks again for your input -- not an easy issue to talk about with anyone.

louise1300 09-28-2017 08:53 AM

Re: Should I Get a Hemorrhoidectomy? You Decide!
I had internals banded about 10 years ago, but the surgeon couldn't band the ones closest to the dentate line because they're too sensitive. Those got progressively worse and worse until they were prolapsing with each movement and were more and more difficult to push back up into the anal canal. They also started to hinder my ability to go daily, and I ended up on a four day cycle. I would have no movements on days 1,2 and 3, but would have about 6 trips to the toilet on day 4. Luckily though, I always had very soft stool, even after it sat there in my bowel for 4 days each time. On the first "go" on day 4, I would experience a sense of fullness afterward (because those prolapsed hemmies would swell up after they were returned to their proper position). On go's 2,3,4,5 6 and sometimes 7 or 8 (over a 2 - 3 hour period), those prolapsed hemmies would start to burn more and more, so that by "go" 3, it would feel like someone had a blowtorch aimed at my bumhole, and I would sit on the toilet dying from the pain. I just wanted to jump off the pot and push them back up as quickly as possible, because for a brief minute or two, that would drop my pain from a 9 to an 8. I would then go lie on the couch in agony until I'd finished 6 or 7 "go's" and then take two Tylenol #4's. Those would help lower the pain to between a 7.5 and a 8.5 (who knows why they were more efffective sometimes than others?), which was a huge relief and I would then lie there for about 10 hours until it dropped down to about a level 4 for the rest of the day. I would usually wake up pain-free the next day, and then have three very "normal person with a life" days, until I hit another dreaded Day 4. After living like that for about a year, I went back to my colo-rectal surgeon and told him that I couldn't stand living like that any more and he did an exam and said that my anal fissure had become worse and recommended a sprincterotomy. I had that a few years ago and things were really great for two years. I started up with the Day 4 cycle again gradually over the last year and finally realized that even though I did have a fissure (had an external tag and internal papilla, and had hit the roof during two different digital rectal exams when the surgeon pressed it!), the majority of my pain had actually been caused by those internal hemmies while prolapsed (I had always been told that internals didn't have many nerve endings, but apparently, if they prolapse and stay that way for long, they can be excruciating). The spincterotomy had loosened up the area so that my stool slid out without being in the tight fissure environment, so had not caused me any trouble until the sphincter tightened up again over that two year period, and sent me back into my four day cycles of terror. While they weren't protruding for those two years, I also had daily, lovely movements (so sad that people like us become fixated on our bowel schedule and stool texture, lol), so life was very good. Back to the four day cycles now again though, is just so depressing (not to mention lying in pain for almost the whole day), because I can't even make appointments more than a day ahead of time, because I occasionally have a day 3 or 5 which makes things impossible to plan for. And so, like you, even though I've made my appointment for the hemorrhoidectomy, I still question whether I'm giving up three good days out of every four, for the risk of things ending up even worse! I can't keep living like this though, and giving up at least 25% of the rest of my life is too much, so I'm biting the bullet and going for it. And with regard to your current surgeon wanting to cut, I see that you're in the US so there is definitely a conflict of interest happening there. Can you get a second opinion? That one would still put the surgeon in a conflict of interest position, but the second one may be more ethical than the first (and maybe that first is genuinely of the belief that you need the procedure, who knows?).

Again though, good luck with your decision.

jliu 08-21-2021 11:28 AM

Re: Should I Get a Hemorrhoidectomy? You Decide!
Hey trike, I saw your post from 2017 about debating whether or not to get your extra skin tags (external hemorrhoid remainders) removed or not. I'm in an almost identical situation where I'm dealing with a minor nuisance that is non-lethal overall, but I'd love to be able to wipe with a clear conscience and not worry about this for the rest of my life. That said, I'm deeply fearful of taking unnecessary risks in the butt region, for all the same reasons you mentioned. Did you ever end up pulling the trigger? Hope either way, all is well with you now!

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