Hemorrhoid Surgery in Ankara, Turkey

Hemorrhoid surgery is a definitive treatment option used for advanced-stage hemorrhoidal disease. During this procedure, enlarged vascular tissues are surgically removed or reduced. Symptoms such as bleeding, pain, and swelling are relieved, significantly improving the patient’s quality of life.

In hemorrhoid surgery, classic hemorrhoidectomy, stapled techniques, or laser-based procedures may be preferred. The choice of method is determined by the stage of the disease and the patient’s overall health condition. Minimally invasive techniques usually offer less pain and a shorter recovery period.

Postoperative care is essential for the success of hemorrhoid treatment. Regular wound care, appropriate nutrition, and adequate fluid intake help accelerate healing. To prevent constipation, a high-fiber diet is strongly recommended.

If advanced hemorrhoids are left untreated, they may cause persistent bleeding, anemia, and a significant decline in quality of life. Surgery eliminates these risks and provides long-term relief, helping the patient return to a healthier and more comfortable life.

You can contact Prof. Dr. Ebru Soy, one of the doctors performing Hemorrhoid Surgery in Ankara, to get information about Hemorrhoid Surgery prices, the process, and the hospital where Hemorrhoid Surgery is performed.

What Are Hemorrhoids?

Hemorrhoids are a common condition caused by the enlargement of veins in the anal and rectal area. They can be classified as internal or external. Factors such as constipation, prolonged sitting, pregnancy, and excessive straining can contribute to their development.

What Causes Hemorrhoids?

Hemorrhoids occur when the veins around the anus and rectum become enlarged and swollen due to increased pressure on these vessels. The following factors may contribute to hemorrhoid development:

• Chronic constipation and straining
• Prolonged diarrhea
• Prolonged sitting (especially on the toilet)
• Pregnancy (pressure from the uterus on the veins)
• Excess weight (obesity)
• Low-fiber diet
• Insufficient water intake
• Heavy lifting
• Genetic predisposition

These factors increase pressure on anal veins and create a predisposition to hemorrhoids. Treatment should also be supported by addressing underlying causes.

What Are the Symptoms of Hemorrhoids?

Hemorrhoids are caused by swollen and enlarged veins in the anal and rectal area. They can be internal or external, and symptoms may vary depending on the type and severity. Common symptoms include:

• Bright red rectal bleeding during or after bowel movements
• Swelling or a palpable lump around the anus (especially with external hemorrhoids)
• Itching, burning, or discomfort
• A sensation of incomplete evacuation after bowel movements
• Pain when sitting (especially if an external hemorrhoid becomes thrombosed)
• Moisture or leakage around the anus

What Is Hemorrhoid Surgery?

To understand what hemorrhoid surgery means, it helps to first understand what hemorrhoids actually are. Contrary to common belief, hemorrhoids are not inherently a disease—these are normal anatomical structures. They can be thought of as small “cushions” located in the last part of the anal canal and containing blood vessels. They serve an important function by contributing to anal closure and helping prevent leakage of gas and liquid stool. In other words, these structures exist in every healthy individual and quietly do their job.

The problem begins when the structure of these cushions changes. What we call “hemorrhoidal disease” occurs when these normal cushions become swollen, loosen, and slide downward due to various reasons. Chronic constipation, prolonged straining on the toilet, pregnancy, aging, or genetic predisposition can cause these vascular structures to enlarge and shift from their original position. At that point, life-disrupting symptoms such as bleeding, protruding lumps, discharge, itching, and sometimes pain may appear.

Hemorrhoid surgery comes into play when diet changes, medications, creams, or office-based procedures such as rubber band ligation are insufficient. The goal is to correct the altered anatomy in a lasting way. In modern surgery, treatment generally follows one or more of three core principles: (1) removing the enlarged and prolapsed hemorrhoidal tissue, (2) locating and tying off the arteries that feed the hemorrhoids to shrink them, or (3) lifting and fixing the displaced cushions back to their normal anatomical position. The most suitable method is always decided on an individual basis, depending on the type and severity of the hemorrhoids.

In Which Situations Is Hemorrhoid Surgery Performed?

A diagnosis of hemorrhoids does not automatically mean surgery is required. In fact, a large proportion of patients can be treated successfully with lifestyle changes and non-surgical procedures. Surgical treatment is usually considered in more advanced stages or when other methods have been tried without success. A simple staging system is used to assess severity, and surgical decisions are often based on this.

Situations in which surgery is clearly considered necessary include:

• Grade 3 hemorrhoids
• Grade 4 hemorrhoids
• Failure of other treatments
• Strangulated (incarcerated) hemorrhoids
• Thrombosed hemorrhoids

To elaborate: Grade 3 hemorrhoids prolapse during bowel movements and can only be pushed back manually. Because they significantly reduce quality of life, surgery is frequently discussed at this stage. Grade 4 hemorrhoids represent the most advanced stage; the tissue remains prolapsed and cannot be reduced. This can cause persistent moisture, soiling, and discomfort, therefore definitive surgical treatment is typically required. Surgery may also be indicated when bleeding and prolapse persist despite diet, medications, and procedures like rubber band ligation. Emergencies may require urgent surgery as well: when prolapsed tissue becomes trapped and its blood supply is compromised, it is called a “strangulated hemorrhoid” and can cause severe pain. Similarly, a “thrombosed hemorrhoid,” caused by sudden clot formation inside the hemorrhoid, may lead to intense pain and occasionally requires urgent surgical intervention.

What Are the Risks of Hemorrhoid Surgery?

All surgical procedures carry some degree of risk by nature, but hemorrhoid surgeries are generally very safe when performed with modern technology and by experienced hands. Before the operation, all potential risks are discussed with patients and concerns are addressed.

Possible postoperative issues include:

• Pain
• Bleeding
• Difficulty urinating
• Infection
• Recurrence
• Anal stenosis (narrowing)
• Gas or stool leakage

Among these, pain is often the greatest concern, especially after classic hemorrhoidectomy. However, pain can be effectively managed with appropriate pain relief and modern approaches. Bleeding is usually mild spotting during the first few days and is considered normal. Rarely, more noticeable bleeding may occur about a week to ten days after surgery, in which case a doctor should be consulted. Difficulty urinating on the first day is typically a temporary reflex related to anesthesia and pain. Although the anal region is not a sterile area, postoperative infection is uncommon. Recurrence depends on the technique used but is generally low with classic surgery. Complications such as anal stenosis and gas/stool incontinence are feared but extremely rare when modern surgical principles are followed carefully—protecting the sphincter muscles is a top priority for competent surgeons.

How Is Hemorrhoid Surgery Performed?

There are multiple modern and effective approaches for hemorrhoid surgery. The choice depends on patient expectations, disease stage, and the surgeon’s experience with the technique. The main approaches include:

Classic Hemorrhoidectomy (Open or Closed)

This is considered the “gold standard” because it provides the most definitive and durable results. The principle is to surgically remove the hemorrhoidal tissue causing symptoms. This can be done with a scalpel, or more comfortably using advanced energy devices such as LigaSure or Harmonic Scalpel, which can reduce bleeding and pain. After removal, the wound can be left open to heal naturally (open technique) or closed with stitches (closed technique).

Advantages:

• Lowest recurrence rate
• Most durable solution
• Applicable to all advanced stages

Disadvantages:

• More postoperative pain
• Longer recovery period

Longo Procedure (Stapled Hemorrhoidopexy)

This method follows a different philosophy. The hemorrhoids are not removed; instead, a special device (stapler) lifts the prolapsed tissue back to its normal position. Because it is performed in an area with limited pain sensation, it is generally more comfortable. The stapler removes a ring of tissue and simultaneously reconnects it with titanium staples. This lifts the cushions and reduces their blood supply, allowing them to shrink.

Advantages:

• Very little pain
• Faster recovery
• Earlier return to work

Disadvantages:

• Higher recurrence risk compared with classic surgery
• Less effective for external hemorrhoids
• Technique-specific rare complications

Modern Minimally Invasive Methods (Laser, HAL-RAR, Radiofrequency)

These approaches aim to treat hemorrhoids internally with minimal or no cutting and therefore minimal pain. They often provide excellent results for Grade 2 and selected Grade 3 hemorrhoids. In Laser Hemorrhoidoplasty (LHP) and Radiofrequency Ablation (RFA), a thin fiber/probe is inserted into the hemorrhoid and controlled energy is delivered to shrink the tissue from within. In HAL-RAR, a Doppler ultrasound probe is used to identify the feeding arteries, which are then tied off with sutures; the hemorrhoids shrink over time, and if prolapse is present, lifting sutures can be added.

Shared advantages:

• Minimal or no pain
• No significant incision or external stitches
• Preservation of normal tissue
• Very fast recovery (often 1–3 days)

Shared disadvantages:

• Lower effectiveness in very advanced disease
• Slightly higher recurrence compared with classic surgery

The Process After Hemorrhoid Surgery

Recovery after surgery varies significantly depending on the technique used. Full recovery after classic hemorrhoidectomy may take a few weeks, whereas patients who undergo minimally invasive procedures such as laser treatment may return to daily activities within a few days. Regardless of the technique, there are shared points that help make recovery smoother and more comfortable:

Key steps in postoperative care include:

• Pain management
• Nutrition and bowel movements
• Local hygiene
• Adequate fluid intake
• Physical activity

Using prescribed pain medications regularly supports pain control. The most critical issue is avoiding constipation, as straining can worsen pain and delay healing. A fiber-rich diet and stool-softening support (when recommended) help keep bowel movements comfortable. Local hygiene is crucial; warm sitz baths provide cleansing, relax the area, improve circulation, and help reduce pain. Drinking at least 2 liters of water per day supports fiber effectiveness and overall recovery. While rest is important in the first days, light walking improves circulation and supports healing. Strenuous sports and heavy activity should be avoided for the period recommended by the physician.

What Those Who Have Hemorrhoid Surgery Should Pay Attention To

A successful hemorrhoid surgery resolves current symptoms, but if the lifestyle habits that contributed to the condition remain unchanged, hemorrhoids may recur in the future. Therefore, postoperative care should be seen not only as a healing period but also as a fresh start toward healthier habits.

Key long-term habits include:

• Fiber-focused nutrition
• Plenty of water intake
• Proper toilet habits
• Regular physical activity
• Maintaining an ideal body weight

Making these habits part of daily life is the most effective way to prevent recurrence. Eating plenty of vegetables, fruits, legumes, and whole grains keeps stools soft and reduces pressure on the anal region. For fiber to work effectively, drinking 2–2.5 liters of water per day is essential. Avoid delaying the urge to use the toilet, and do not sit or strain for long periods. Regular exercise supports bowel motility, and reaching/maintaining a healthy weight reduces intra-abdominal pressure. Preventive habits are not only an investment for hemorrhoid prevention, but also for overall health.