HEMORRHOID TREATMENT & SURGERY NYC
NATIONALLY TRUSTED, PROFESSIONAL HEMORRHOID TREATMENT & SURGERY
Hemorrhoids result from increased pressure in the veins of the anus causing them to expand. We specialize in surgery and treatment to provide relief from pain caused by hemorrhoids. Visit our NYC office or give us a call today to learn more about how we can help.
Bespoke Surgical’s hemorrhoid treatment NYC practice provides hand-tailored, expert care for every patient. We would be happy to help you with any questions or treatment options for your hemorrhoids. Consider contacting us if you’re in need of a hemorrhoid removal or treatment.
WHAT ARE HEMORRHOIDS?
Hemorrhoids are swollen veins in the anus or lower rectum that can cause discomfort, itching, or bleeding. They can be internal, external, or a combination of both, depending on their location. Essentially, they’re the result of increased pressure in the area, whether from straining during bowel movements, pregnancy, or prolonged sitting, and can even develop from anal sex. While common and often manageable, they can sometimes require medical treatment to improve both function and comfort.
HEMORRHOID TREATMENT
NON-SURGICAL HEMORRHOID TREATMENT
Non-surgical hemorrhoid treatments are very effective, but unless dietary and lifestyle changes are made, they may recur. If symptoms persist or are severe, an anal hemorrhoid surgeon may be required. We provide the following hemorrhoid surgeries locally at our New York office:
- Cauterization – Using either an electric probe, a laser beam, or an infrared light, a burn seals the end of the hemorrhoid, causing it to close off and shrink.
- Banding – Prolapsed internal hemorrhoids are often removed using rubber-band ligation in the office. A special instrument secures a tiny rubber band around the hemorrhoid shutting off its blood supply, causing it to fall off within a week. Banding is not an option for large internal hemorrhoids or ones that encroach externally. If placed on ones with that mild muscle or external component, it can be quite uncomfortable and without efficacy.
HEMORRHOID SURGERY
- Hemorrhoidectomy – For large internal hemorrhoids, uncomfortable external hemorrhoids, thrombotic hemorrhoids, or mild hemorrhoids with large remaining skin tags, a hemorrhoidectomy is warranted by an anal hemorrhoid surgeon. During a hemorrhoidectomy, the surgeon makes small incisions around the anus to cut the hemorrhoids off. The doctor often applies local anesthesia to numb the area or general anesthesia to put the patient to sleep. After a hemorrhoidectomy, the patient may require stitches, but can normally go home the same day. A formal hemorrhoidectomy is a wonderful approach in the gay community, since it allows also for the removal of tags and restoration of the canal to allow for maximal pleasure, with the aesthetics one desires.
- Procedure for prolapse and hemorrhoids – Another anal hemorrhoid surgical option is called the procedure for prolapsed hemorrhoids (PPH). This is using a circular device and stapling the hemorrhoidal tissue in a 360-degree manner. It is highly effective, though in the anal intercourse world it is not recommended since the staple line internally will be present; leading to irritation, pain, and an adverse outcome for the giver.
AFTER HEMORRHOID SURGERY
WOUND CARE
The location of the hemorrhoid that is targeted and surgically removed affects whether the region excised is closed primarily with sutures or left open to heal by secondary intention. Clearly, one would love to close all areas, but understanding both the anatomy and healing capacities of such, limits what one can do intra-operatively.
- Sutures in Place – Leave the absorbable stitches alone. There are two rows, one continuous and the other interrupted that keep all intact. However, this is not like a cut on the arm or torso, which has limited forces against healing. We have to defecate daily and this act causes significant pressures to be had in the anal region. This, in turn, can cause stress and strain on the stitch work. Do not fret if some or all of the stitches open up. I am expecting some to do so, hence why we do two rows and place several in that region. Continue to follow instructions on the use of creams, stool softeners, and Epsom salt baths. Do not use suppositories in the immediate post-operative period and refrain from inserting anything into the anus unless instructed, such as Preparation H creams. The key is to keep everything clean and dry, as well as use more abrasive exfoliating soaps to help along the healing process. Place a piece of gauze to catch any excrement, such as drainage, which is quite normal. This will heal nicely even if opened. In the office, I will remove any unwanted lingering sutures and cauterize the open wound. This will encourage closure and will heal aesthetically as planned. Of course, let us know if opening occurred and we can spearhead the above to ensure appropriate healing.
- Wound Left Open – This, again, is strategically done due to the hemorrhoid’s location and these heal quite fast with the aesthetic result we all intended. In this case, using suppositories, like Calmol-4, is suggested, along with Preparation H, stool softeners, and Epsom salt baths. Exfoliating soaps, once one can tolerate, are key to getting rid of the daily grime that develops. The body’s normal mechanism is to produce mucus to cover the open wound; however, the mucus limits healing, which is why I recommend a twice daily routine of exfoliation to get rid of this. In the office, during the initial 3 and 6 week post-operative visits, I will cauterize the open wound to encourage healthy tissue and subsequent closure.
- Both Closed and Open Wounds – Some people have both open and sutured regions following their surgical procedures, specifically if there is multiple hemorrhoids and tags needing removal. Please follow the sutured algorithm if this is indeed the case.
- Botox – In many hemorrhoidal cases, we utilize Botox to assist in relaxation, which ultimately improves healing and subsequently anal engagement. Botox takes 2-3 days to start working and the action is to loosen that region. One will not defecate on the street, per se, but if you feel the need to pass gas or to defecate, I suggest going to the bathroom sooner rather than later. People do get more of a sense of urgency and flatulence, which can lead to limited control in the initial immediate postoperative period, specifically when we are using gentle laxatives and softeners to assist healing and minimize pain. This will improve daily and usually is present during the first one to two weeks. Remember: Botox in these cases is key to the healing process and is imperative to its success.
- Tags Developing – Do not fret if some new small skin tags develop in the suture or wound lines. This can happen and is a normal process. During the initial postoperative visit, they are easily handled in the office with local treatments to rid and encourage appropriate outcomes.
- Infections – Very rarely in the closed format an infection may develop. Redness and purulent drainage can occur usually post op days 3-7 and it’s more of a detour away from positive daily improvement. One may see some swelling and the above localized redness, along with potential fevers and chills. Please let us know if you experience this so that we may prescribe antibiotics and possible drainage, if necessary. Though rare, it can happen and we should all be knowledgeable on this unfortunate outcome. Even if this occurs, everything is manageable.
- Discoloration and Loss of Melanin – In darker skin types, a disclaimer pre and post operatively is warranted as scars can heal with a loss of pigment. Please understand that this is not a surgical complication, but rather more about the healing within specific skin types. It is still rare, but if it happens, even though most of the time they go unnoticed, one can bleach the region to blend its lighter, pinker scar line or have that patch of skin tattooed to match the surrounding skin.
- Packing – I place a piece of packing in the anal canal in all of my surgical patients. This is to stop any unwanted bleeding. It will come out during the first defecation and looks like a piece of skin. Do not fret. It is not your skin and if you do see it in the toilet bowl, it is normal and should be flushed away.
Following these postoperative instructions and understanding the entire healing process for both open and closed wounds, with or without Botox, will maximize not only the recovery, but also allow for appropriate healing and the ultimate functional and aesthetic results we all are seeking. In some cases, the use of a bidet can be beneficial during the recovery process.
What is the best hemorrhoid treatment?
The best treatment for hemorrhoids depends on their type—internal, external, or a combination—and their severity. Treatment options range from rubber band ligation and cautery or laser procedures, to a formal hemorrhoidectomy, which removes both internal and external hemorrhoids. This often addresses functional or aesthetic concerns like external skin tags. At Bespoke Surgical, we will develop a tailored treatment plan by considering the patient’s specific needs, including how the anus is used, whether for defecation, anal sex, or both.
How long does it take to recover from hemorrhoid surgery?
Recovery time varies depending on the treatment. Banding typically requires one week of pressure and about a month of healing before starting dilation for anal sex, while a formal hemorrhoidectomy with stitches takes 6-8 weeks for full recovery. The initial days can be painful (managed with prescribed narcotics), followed by two weeks of discomfort during bowel movements, but using NSAIDs, Tylenol, and Botox to relax the anal muscles can aid in easing recovery.
What should I eat after hemorrhoid surgery?
Post-operative recovery often begins with stool softeners, a gentle laxative, and a gradual return to normal eating, due to the use of anesthesia during surgery. The goal is to maintain easy, strain-free bowel movements, and balancing diet and medication to avoid stools that are too hard or overly frequent. Staying hydrated, walking regularly, and transitioning back to a routine diet are essential to resuming normal habits and ensuring proper recovery.
What should I expect after hemorrhoid surgery?
To help guide patients through their recovery and what they can expect, please visit our post-operative instructions.
How much bleeding is normal with a hemorrhoid?
Most patients should expect some bleeding and it may get worse after a week or so as the scabs fall off. However, hemorrhaging and excessive bleeding is not supposed to happen. In other words, it shouldn’t be like a faucet. If there’s blood, our recommendation is to stand up and place gauze that’s been soaked in Afrin on the hole. You’ll also want to stop the use of any blood thinners, like Advil or Motrin. Most patients find that using gauze and placing pressure on the area will usually stop the bleeding in this situation.
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NEW YORK
44 East 12th Street, Suite MD1
New York, NY 10003
Phone: (212) 206-1501
Email: info@bespokesurgical.com
Bespoke Surgical is located in Manhattan, in the Greenwich Village neighborhood, and easily accessible by car or public transportation.
For patients with questions outside of normal business hours regarding post-surgical care, trying anal play, or irregular bowel movements, please reference our after-hours support guide for more information. Those patients who feel as though they’re having a more serious medical emergency should immediately call 911.
