Hemorrhoid surgery (hemorrhoidectomy) is the most effective treatment for hemorrhoids. It frequently eliminates hemorrhoids with no recurring symptoms. When symptoms do recur, they are rarely severe enough to require additional surgery.

However, hemorrhoidectomy does pose certain risks. Complications can be minimized with proper surgical technique during the procedure and adequate pain control, attention to fluid intake and proper use of bulking laxatives and stool softeners after the surgery. Patients are urged to discuss the use of laxatives with their physicians. Complications of hemorrhoidectomy may include:

• Pain. Pain is very common following hemorrhoid surgery, as with many other surgeries. The degree of pain varies between patients. Pain relievers are administered to relieve pain.
  
  
• Urinary retention. Difficulty emptying the bladder. This temporary complication may occur, depending upon several factors. These include the amount of fluids given during and after surgery, the degree of pain the patient experiences and whether the patient has a history of difficulty emptying the bladder. In some cases, patients may require a catheter to drain the bladder. The need for catheterization can be reduced by limiting fluid intake and using pain medications and warm sitz baths. A physician will be able to determine the risk of this complication and suggest proper levels of fluid intake and other prevention and treatment measures.
  
  
• Urinary tract infections. These occur in some patients and may be a result of urinary retention.
  
  
• Fecal impaction. A mass of hardened feces becomes lodged in the rectum. This may be due to the pain following surgery, which worsens with defecation. This may cause patients to hold in their stool to lessen their pain. Holding in stool is a common cause of fecal impaction. The use of narcotic pain relievers may also be a factor. Bulk fiber, stool softeners and stimulant laxatives are generally effective in preventing fecal impaction. In some cases, fecal impaction may require manual removal while the patient is anesthetized.
  
  
• Delayed bleeding. A few patients may experience bleeding seven to 16 days after hemorrhoid surgery. It is generally believed to be caused by the shedding of tissue that has been operated on and tends to require closing with stitches.
  
  
• Anal stenosis. Narrowing of the anal canal. This is a long-term complication. It may result from the removal of too much tissue around the hemorrhoids.
  
  
• Submucosal abscess. An infection of the tissue just below the anal or rectal lining, resulting in an abscess (a collection of pus). This is a very rare complication that, even more rarely, can result in death.

In addition, hemorrhoidectomy carries the risks common to all surgeries including bleeding, skin infection and allergic reaction to anesthesia.

Hemorrhoid surgery is not always an option. For example, it is not used in patients with Crohn's disease of the rectum, which is a form of inflammatory bowel disease. In this condition, the intestinal tract is easily irritated. Hemorrhoid surgery on a patient with Crohn’s disease is much more likely to cause serious complications. In cases such as these, the risks of hemorrhoid surgery outweigh the benefits.