Remove internal and/or external hemorrhoids.

Medically Reviewed by Dr. Harper Niver

Updated 11 January 2022

Hemorrhoids are bulging veins within the anal canal that can cause rectal bleeding or pain during defecation. (3) These veins are normal but can sometimes become enlarged due to chronic constipation or during pregnancy. (6) Almost half of the population aged 50+ suffers from symptomatic hemorrhoids. (5) They are found equally prevalent in men and women. 

There are two types of hemorrhoids: internal and external. External hemorrhoids can be seen along the anus and are known for being extremely painful. Internal hemorrhoids are within the anal canal and typically present with asymptomatic bleeding with bowel movements. 

Surgical intervention is rarely the first option considered for symptomatic hemorrhoids. However, when all else fails, hemorrhoidectomy (surgical removal of hemorrhoidal tissue), is a safe and efficient procedure that can help eliminate the problem. 

Proctologist points to an internal hemorrhoid.

When is a Hemorrhoidectomy Appropriate?

Hemorrhoids can be a nuisance, but the good news is that they don’t always require surgery and can be treated using non-invasive methods, such as changing one’s diet.

Hemorrhoidectomy is appropriate when you have: (3)

  • Very large internal hemorrhoids
  • Failed medical management
  • Hemorrhoids that protrude from the anal region, causing pain and making it difficult to keep the area clean.
  • Failed rubber band ligation

Current treatment of internal hemorrhoids based on their severity and degree of prolapse. DG-HAL: Doppler-guided hemorrhoidal artery ligation; SH: Stapled hemorrhoidopexy; PPH: Procedure for prolapse and hemorrhoids. (3)

Hemorrhoids Treatment Indications

Current treatment of internal hemorrhoids based on their severity and degree of prolapse. DG-HAL: Doppler-guided hemorrhoidal artery ligation; SH: Stapled hemorrhoidopexy; PPH: Procedure for prolapse and hemorrhoids. (3)

What is the Procedure for a Hemorrhoidectomy?

A hemorrhoidectomy is performed in a hospital or outpatient surgery center. In most cases, it’s an outpatient operation, but an overnight stay may be required for some patients.

There are two options for sedation: either general anesthesia or local anesthetic with a dose of analgesic.

In order to see the hemorrhoids more clearly, the surgeon will place a scope in your anal canal while you are unconscious. A scalpel or electrocautery will be used to remove the hemorrhoidal tissue, and dissolvable sutures will subsequently be used to close the incision. This procedure is known as a “closed hemorrhoidectomy”. The incision may not be sutured in some instances, such as when there is a high risk of infection or when the region is particularly large. This procedure is termed an “open hemorrhoidectomy.”

Hemorrhoidopexy is a less invasive surgery than hemorrhoidectomy. Staples are used to stop blood flow, remove redundant tissue, and raise hemorrhoids into the anal canal. The risk of recurrence and rectal prolapse is increased with this technique.

The above procedures typically lasts less than an hour.

What is the Cost of a Hemorrhoidectomy?

The cost of a hemorrhoidectomy varies by location and by clinic. Below is a list of average prices by country for the procedure.

Hemorrhoidectomy Price Table
Country Price
United States of America $5,040
Mexico $2,000

Cost data estimated from information gathered by Wesley Jacobs of Apollo Medical Travel based on publicly available price information in the United States and of providers offering hemorrhoidectomy procedures in Apollo’s network of clinics. Prices vary widely between hospitals and clinics.

What are the Risks Associated With a Hemorrhoidectomy?

There are risks associated with a hemorrhoidectomy as there are with any surgical procedure. Generally, they include bleeding, infection, or recurrence. 

Risks of Specific to Hemorrhoidectomy: (1)

  • Anal stricture (narrowing of the anal canal)
  • Urinary retention or difficulty urinating
  • Impaction of the feces (hard stool that is trapped in the anal canal)
  • Incontinence of the bowels (leaking a small amount of stool)
  • Pain during bowel movements
  • Hemorrhoid recurrence

Post-op Hemorrhoidectomy Care

By adhering to your treatment plan, you can lower the chance of certain complications: (3)

  • Maintaining a regular bowel movement schedule is essential to preventing constipation. A stool softener, more fiber in your diet, and eight to ten glasses of water a day may be necessary to alleviate this problem.
  • Avoid heavy lifting and strenuous physical activity until cleared by your medical provider
  • If you’re concerned about bleeding, fever, increase in pain, or wound redness, swelling — let your doctor know immediately.


Hemorrhoids are normal veinous tissue within the anal canal that can become enlarged, painful, and cause rectal bleeding. If you have failed medical management, hemorrhoidectomy might be right for you.  Most people get back to their normal healthy life within a few weeks. See your healthcare provider if it takes you longer to recover or if you have concerns for possible complication.

Additional Resources


  1. Corno F, Muratore A, Mistrangelo M, Nigra I, Capuzzi P. Le complicanze della terapia chirurgica delle emorroidi ed il loro trattamento [Complications of the surgical treatment of hemorrhoids and its therapy]. Ann Ital Chir. 1995;66(6):813-816.
    Read on PubMed
  2. Champigneulle B, Dieterling P, Bigard MA, Gaucher P. Etude prospective de la fonction sphinctérienne anale avant et après hémorroïdectomie [Prospective study of the function of the anal sphincter before and after hemorrhoidectomy]. Gastroenterol Clin Biol. 1989;13(5):452-456.
    Read on PubMed
  3. Lohsiriwat V. Treatment of hemorrhoids: A coloproctologist’s view. World J Gastroenterol. 2015;21(31):9245-9252. doi:10.3748/wjg.v21.i31.9245
    Read on PubMed
  4. Cengiz TB, Gorgun E. Hemorrhoids: A range of treatments. Cleve Clin J Med. 2019;86(9):612-620. doi:10.3949/ccjm.86a.18079
    Read on PubMed
  5. Fox A, Tietze PH, Ramakrishnan K. Anorectal conditions: hemorrhoids. FP Essent. 2014;419:11-19.
    Read on PubMed
  6. Lee JH, Kim HE, Kang JH, Shin JY, Song YM. Factors associated with hemorrhoids in korean adults: korean national health and nutrition examination survey. Korean J Fam Med. 2014;35(5):227-236. doi:10.4082/kjfm.2014.35.5.227
    Read on PubMed

This article is intended for informational purposes only. It is not meant to be used as medical advice, diagnosis, or treatment. Always seek the advice of a qualified health provider with any questions you have surrounding a medical condition. Never disregard professional medical advice or delay in seeking it as a result of anything you read on this Site. 

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