“Is hemorrhoid surgery very painful?” ... Is there a hemorrhoid operation that doesn’t involve the anus? [Health Talk]

[Financial News] “Isn’t hemorrhoid surgery very painful?” This is the first question patients with hemorrhoids often ask as they hesitate to undergo surgery. It is only natural to be concerned, since the anus is sensitive to pain, but depending on the patient’s condition, there are surgical methods that can reduce the burden of pain.
Jung Seong-woo, chief of surgery at Incheon Sejong Hospital, said, “Some patients delay treatment because they fear postoperative pain, even when their hemorrhoids repeatedly prolapse outside the anus,” adding, “Depending on the patient’s condition, stapled hemorrhoidopexy (PPH) using a circular stapler may be considered for prolapsed internal hemorrhoids.”
Hemorrhoids, commonly known as piles, are a condition in which the vascular tissue around the anus becomes enlarged or slips downward, causing bleeding, pain, or prolapse. In the early stages, symptoms can be managed with medication and changes to diet and bowel habits. However, surgery should be considered if the hemorrhoids repeatedly prolapse or bleeding and discomfort persist.
PPH surgery uses a specialized circular stapler to remove and staple a circular section of the elongated rectal mucosa and submucosal tissue above the dentate line. This moves the prolapsed internal hemorrhoidal tissue back up and reduces blood flow to the hemorrhoidal tissue, improving prolapse symptoms.
Traditional excisional hemorrhoid surgery directly removes hemorrhoidal tissue around the anus, whereas PPH surgery corrects the prolapse by lifting the elongated tissue upward. Since the main steps of the operation are performed on the rectal mucosa above the anus, rather than around the pain-sensitive anus itself, PPH may relatively reduce postoperative pain and help with recovery.
PPH surgery is suitable for patients whose main symptom is internal hemorrhoids prolapsing outside the anus during bowel movements. It may be considered especially when the hemorrhoids prolapse repeatedly or need to be pushed back in by hand. However, it is not suitable for every patient with hemorrhoids. The appropriate surgical method may vary depending on the location and size of the hemorrhoids, the extent of prolapse, and whether external hemorrhoids are also present, so an accurate diagnosis must come first.
Chief Jung explained, “PPH surgery works differently from an operation that removes hemorrhoids by making an incision directly around the anus,” adding, “If you’re concerned about pain, PPH surgery may be one option.”
Jung emphasized, “Many people put up with symptoms because hemorrhoids are common, but if prolapse or bleeding recurs, they should get an accurate diagnosis,” adding, “The important thing is not to assume that a particular surgical method is always best, but to choose a treatment suited to the patient’s hemorrhoids and symptoms.”


[email protected] Medical Correspondent Jung Myung-jin Reporter