Consent: Haemorrhoidectomy

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.

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