Consent: Haemorrhoidectomy - Podcast Version TeachMeSurgery 0:00 / 0:00 1x 0.25x 0.5x 0.75x 1x 1.25x 1.5x 1.75x 2x This article is for educational purposes only. It should not be used as a template for consenting patients. The person obtaining consent should have clear knowledge of the procedure and the potential risks and complications. Always refer to your local or national guidelines, and the applicable and appropriate law in your jurisdiction governing patient consent. Overview of Procedure Haemorrhoids are swollen blood vessels within the anal canal. Management for severe haemorrhoids involves their removal surgically, termed a haemorrhoidectomy. Complications Intraoperative Complication Description of Complication Potential Ways to Reduce Risk Haemorrhage This occurs in 5% of haemorrhoidectomies, and usually stops spontaneously. Anaesthetic risks Includes damage to the teeth, throat and larynx, reaction to medications, nausea and vomiting, cardiovascular and respiratory complications. Forms a part of the anaesthetist assessment before the operation Early Complication Description of Complication Potential Ways to Reduce Risk Pain This is a notoriously painful operation and patients should be warned of this. Eat a high fibre diet and prescribe a stool softener and plenty of fluid Infection Superficial wound infection is possible but rare. Flatal or faecal incontinence This is usually temporary but may be permanent. Leave mucosal bridges between haemorrhoids Anal stricture The anus may become narrowed and tighter due to shrinkage of scar tissue, making it difficult to pass stool. Leave mucosal bridges between haemorrhoids Blood clots DVTs and PEs are a possibility in any operation. The risk is increased in patients with a raised BMI, on the pill, recent flights, previous DVT, pregnancy, smokers, cancer and prolonged bed rest. The patient will be given anti-embolism stocking and low molecular weight heparin peri-operatively to minimise this risk as deemed appropriate. Urinary retention This is common post-haemorrhoidectomy and may require catheterisation. Stroke, MI, kidney failure, death Although small, this is always a risk in any major surgery Late Complication Description of Complication Potential Ways to Reduce Risk Recurrence There is always a potential for further haemorrhoids to occur in the future. Frequent questions What is a haemorrhoidectomy? A haemorrhoidectomy is a surgical procedure to remove swollen blood vessels, known as haemorrhoids, from the anal canal. It is typically indicated for severe cases where conservative management has failed. What are the common complications associated with a haemorrhoidectomy? Common complications include haemorrhage, infection, pain, flatal or faecal incontinence, and anal stricture. Awareness and management strategies can help mitigate these risks. How can the risk of pain after a haemorrhoidectomy be reduced? To minimise postoperative pain, patients should be advised to consume a high-fibre diet, alongside stool softeners and adequate fluid intake. This can help ease bowel movements during recovery. What are the potential late complications following a haemorrhoidectomy? Late complications may include the recurrence of haemorrhoids and complications such as urinary retention. Patients should be informed about these risks during the consent process. What measures are taken to prevent deep vein thrombosis (DVT) after a haemorrhoidectomy? To prevent DVT, patients may receive anti-embolism stockings and low molecular weight heparin peri-operatively, especially those with risk factors such as a high BMI or prolonged bed rest. These measures aim to enhance patient safety during recovery. Rate This Article