Piles Surgery Singapore

Indications Benefits Techniques Preparation Procedure Recovery Risks FAQ

Piles surgery, or haemorrhoidectomy, is a medical procedure used to remove swollen or prolapsed haemorrhoids that no longer respond to conservative treatment. These haemorrhoids may cause persistent discomfort, pain, or bleeding. Piles surgery in Singapore is typically performed by a registered colorectal and general surgeon and aims to provide long-term relief and restore comfort during bowel movements.

For those experiencing ongoing haemorrhoid symptoms, early medical evaluation is important.

When Is Piles Surgery Necessary?

Surgery is typically considered when non-surgical treatments such as high-fibre diets, stool softeners, topical creams, or office-based procedures like rubber band ligation fail to provide adequate relief. Common situations that may warrant surgery include:

Grade 3 or 4 haemorrhoids: These are large internal haemorrhoids that prolapse outside the anal opening and either cannot be pushed back in manually or recur shortly after being repositioned.

Persistent bleeding: Chronic bleeding during or after bowel movements, particularly when it leads to anaemia or fatigue, may indicate that the haemorrhoids are too advanced for conservative management.

Severe pain or discomfort: Some haemorrhoids cause ongoing pain, itching, or irritation that interferes with work, rest, or daily activities.

Thrombosed external haemorrhoids: These occur when blood clots form within external piles, causing sudden and intense pain, swelling, and inflammation.

Recurring episodes: Individuals who experience frequent flare-ups of haemorrhoids despite treatment may benefit from surgical removal to prevent future complications.

If you’re unsure whether your symptoms of haemorrhoids require medical attention, it is best to consult a qualified colorectal specialist who can perform a thorough evaluation, recommend appropriate investigations.

Benefits of Piles Surgery

Piles surgery offers several important advantages, especially for those with severe haemorrhoid problems:

Long-term symptom relief

Once the affected tissue is removed, most individuals experience a complete resolution of pain, bleeding, and prolapse. This improvement can significantly enhance day-to-day comfort and make routine activities, such as walking, sitting, and going to the toilet, much more manageable.
Prevention of complications

Severe haemorrhoids that are left untreated may become strangulated, thrombosed, or infected, all of which can lead to additional pain and complications. By addressing the condition surgically, these risks are greatly reduced.
Restoration of anal anatomy

Helps improve hygiene and reduce the likelihood of future recurrences, especially when paired with proper post-operative care and lifestyle changes.

Surgical Techniques for Piles Surgery in Singapore

Several surgical approaches are available for piles surgery in Singapore, depending on the type and severity of the condition. The choice of technique depends on the type, size, and location of the haemorrhoids, as well as the patient’s overall health.

Milligan-Morgan Technique

Also known as the open technique. This technique involves removing the haemorrhoidal tissue and leaving the wounds open to heal naturally over time. This method is often used for more severe or extensive haemorrhoids and has a high success rate.

Ferguson Technique

Also known as the closed haemorrhoidectomy. This technique involves suturing the surgical wounds. Some patients may experience less post-operative discomfort and faster recovery with this method, although outcomes are generally comparable to the open approach.

Stapled Haemorrhoidopexy

Also known as PPH (Procedure for Prolapse and Haemorrhoids). This technique uses a circular stapling device to remove a ring of tissue from the rectal lining, effectively repositioning the prolapsed haemorrhoids back into place. It is usually associated with less pain and quicker return to activity but may not be suitable for all types of piles.

Harmonic Scalpel Haemorrhoidectomy

A technique that cuts and seals tissue simultaneously using ultrasonic vibrations. This may reduce bleeding during surgery and lessen the need for stitches.

Preparing for Piles Surgery

Proper preparation helps ensure the best possible outcome from your piles surgery.

Pre-operative medical evaluation

You will undergo a thorough assessment including blood tests, medical history review, and physical examination to ensure you are fit for surgery.

Medication adjustments

Your surgeon will review all current medications and may ask you to stop certain blood-thinning medications or supplements before surgery to reduce bleeding risk.

Bowel preparation

You may be given specific instructions about bowel preparation, including dietary restrictions and possibly an enema or laxatives to clear the bowel before surgery.

Fasting instructions

You will need to avoid eating and drinking for a specified period before surgery, typically 6-8 hours, as directed by your surgical team.

What Happens During Piles Surgery

Here’s what to expect during piles surgery in Singapore:

Anaesthesia administration

You will receive either general anaesthesia or spinal anaesthesia, depending on your surgeon’s recommendation and your medical condition.

Surgical site preparation

The anal area is thoroughly cleaned and draped with sterile covers to maintain a sterile surgical environment.

Haemorrhoid identification and dissection

Your surgeon carefully identifies each haemorrhoid and begins the dissection process, separating the haemorrhoidal tissue from surrounding healthy tissue.

Haemorrhoid identification and dissection

Vessel ligation and tissue removal

Blood vessels supplying the haemorrhoids are carefully tied off or sealed, and the haemorrhoidal tissue is completely removed.

Wound management

Depending on the technique used, the surgical sites may be left open to heal naturally or closed with dissolvable sutures.

Final inspection and dressing

The surgeon performs a final check of the surgical area and applies appropriate dressings or packing as needed.

Post-Surgical Care and Recovery

Immediate Care

Pain management: You will receive prescribed pain medications to manage post-operative discomfort, and your medical team will monitor your pain levels closely.

Monitoring for complications: Hospital staff will observe you for any signs of bleeding, infection, or other immediate complications before discharge.

Initial mobility: You will be encouraged to move around gently as soon as it is safe to do so, which helps prevent complications and promotes healing.

Recovery Timeline

After the surgery, most patients experience mild to moderate pain, particularly during bowel movements. Pain management is an important part of recovery, and your doctor will prescribe medications to keep you comfortable.

In the first few days, you may notice some bleeding, especially with your first few bowel movements. This is normal and typically subsides within a week. Maintaining proper hygiene is essential. Warm sitz baths and gentle cleaning can help reduce irritation and prevent infection.

Most patients can resume light daily activities within 1 to 2 weeks. However, strenuous physical activities such as heavy lifting or intense exercise should be avoided for 4 to 6 weeks or until your surgeon gives the go-ahead. Full healing usually occurs within a month, and most patients return to their regular routines with proper management after piles surgery.

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Potential Risks and Complications

As with any surgery, there are some risks involved including post-operative pain, mild bleeding, or difficulty passing urine. In some cases, patients may develop an anal stricture, which is a narrowing of the anal canal. Rarely, temporary issues with bowel control may occur.

Most of these complications are short-term and can be managed effectively with medical care. Serious long-term complications are uncommon when the surgery is performed by a trained and experienced colorectal surgeon.

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Frequently Asked Questions

How much does piles surgery cost in Singapore?

Costs vary depending on the technique used and hospital setting. Private treatment may range from several thousand to over ten thousand dollars. You can also explore public vs private charges at MOH Fee Benchmarks.

What should I do if I experience severe pain after surgery?

Some discomfort is normal, but severe or worsening pain should be reported to your surgeon immediately as it may indicate complications requiring medical attention.

Can I prevent haemorrhoids from returning after surgery?

While surgery removes existing haemorrhoids, maintaining a high-fibre diet, staying hydrated, avoiding prolonged sitting, and not straining during bowel movements can help prevent new ones from forming.

When can I resume sexual activity after piles surgery?

Most patients can resume sexual activity once they feel comfortable, typically after 2-3 weeks, though you should discuss this with your surgeon during follow-up appointments.