Risks and Complications of Surgery

Alongside the significant post-operative pain covered in its own dedicated page, hemorrhoid surgery carries a specific set of possible complications worth understanding honestly before proceeding.

Common, generally manageable complications

• Urinary retention — difficulty urinating in the immediate post-operative period, one of the more commonly reported issues after anorectal surgery, generally managed with temporary catheterization if needed and resolving as recovery progresses
• Bleeding — some bleeding is expected as part of normal healing; heavier or persistent bleeding needs medical attention
• Pain — covered in detail in its own dedicated page given its significance and frequency
• Difficulty with the first bowel movement — a specific, commonly anticipated challenge (see recovery content on this site)

Less common but more serious risks

• Anal stenosis — narrowing of the anal canal, a longer-term complication more associated with more extensive circumferential excision; can require further treatment (dilation or, in more significant cases, surgical correction) if it develops
• Fecal incontinence — uncommon, but a genuine risk particularly with certain more extensive techniques or in patients with pre-existing risk factors (previous obstetric injury, prior anorectal surgery); worth a specific, direct conversation with your surgeon about your individual risk given your history
• Infection — as with any surgical procedure, though generally uncommon with appropriate post-operative care
• Delayed wound healing — more relevant to open (Milligan-Morgan) technique, given the wound is left to heal by itself rather than being closed

How risk varies by technique and individual factors

Different surgical approaches carry somewhat different specific risk profiles — for example, stapled hemorrhoidopexy carries its own distinct set of possible complications (including rarer but more serious ones like rectal perforation) compared to traditional excisional hemorrhoidectomy (see the dedicated pages for each technique for specifics). Your individual risk also depends on factors like the extent of your disease, prior anorectal surgery, and overall health — see Surgery with comorbidities for how underlying health conditions factor in.

What actually reduces these risks

• Choosing an experienced surgeon with specific expertise in the recommended technique
• Following pre- and post-operative instructions closely, including proactive stool softener use to avoid straining during healing
• Prompt reporting of any concerning symptoms (fever, significant bleeding, inability to urinate) rather than waiting to see if they resolve

When to seek urgent care after surgery

• Fever
• Heavy or worsening bleeding
• Inability to urinate
• Severe pain significantly beyond what was described as expected
• Any symptom that feels disproportionate to what your surgical team described as a normal part of recovery

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This page is for general education. Your surgeon can give you a risk assessment specific to your planned procedure and individual health history.