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| Haemorrhoidectomy (Piles operation) |
These notes give an overall guide to your stay in hospital. You may see some differences in the details of your treatment, since it is tailored to suit your own condition.
WHAT ARE PILES? Piles are the loose vascular (blood containing)cushions on the wall of the anal canal that may bulge out through the ring muscle (sphincter) which holds the back passage shut. They contain big blood vessels which may bleed with bowel actions or protrude out of the anal canal on straining. They can clot up when stuck outside causing pain. Prolapse can result in loose skin which may produce irritating tags.  The ring muscle is slightly stretched and the piles are trimmed off. Reception When registering at reception your medical aid details will be required. Your medical aid may require that you obtain an authority number from them for the hospital. Please check this. If you are not on a member of a medical aid you will be required to pay a deposit or to sign an indemnity form. As far as possible we will try to advise you about hospital costs before your admission. Welcome to the ward You will be welcomed to the ward by the nurses or the receptionist and will have your details checked. Some basic tests will be done such as pulse, temperature, blood pressure and urine examination. You will be asked to hand in any medicines or drugs you may be taking, so that your drug treatment in hospital will be correct. Please tell the nurses of any allergies to drugs or dressings. The surgeon will have explained the operation and you will be asked to sign your consent for the operation. If you are not clear about any part of the operation, then read this again and then ask for more details from the surgeon or from the nurses. Visit by the anaesthetist If you are having a general anaesthetic, the anaesthetist who will be giving your anaesthetic will interview and examine you. He will be especially interested in chest troubles, dental treatment and any previous anaesthetics you have had. Diet You will be asked to have nothing to eat or drink for 6 hours before so that your stomach is empty for the operation. Premedication You may be given a sedative injection or tablets about 1 hour before the operation. You will be given an enema before the operation. The operation is then performed WHAT HAPPENS AFTER THE OPERATION? Coming round after the anaesthetic Although you will be conscious a minute or two after the operation ends, you are unlikely to remember anything until you are back in your bed on the ward. Some patients feel a bit sick for up to 24 hours after operation, but this passes off. You will be given some treatment for sickness if necessary. Will it hurt? There is some discomfort on moving rather than severe pain. You will be given injections or tablets to control this as required. Ask for more if the pain is still unpleasant. You will be expected to get out of bed the day after operation despite the discomfort. You will not do the wound any harm, and the exercise is very helpful for you. The second day after operation you should be able to spend most of your time out of bed and in reasonable comfort. You should be able to walk slowly without too much discomfort. By the end of one week the wound should be virtually painfree. Drinking and eating You will be able to drink within an hour or two of the operation provided you are not feeling sick. The next day you should be able to manage small helping of normal food. Opening the bowels It is quite normal for the bowels not to open for a day or so after the operation. You will be given a bulking laxative such as Fybogel or Agiolax and possibly liquid paraffin. The first time you open your bowels it may be a bit painful but this rapidly improves. Once your bowels have opened you can make plans to go home. Passing urine It is important that you pass urine and empty your bladder within 6-12 hours of the operation. If you find using a bed pan or a bottle difficult, the nurses will assist you to a commode or the toilet. If you still cannot pass urine let the nurses know and steps will be taken to correct the problem. What about the periods? Menstrual bleeding at the time of your operation presents no problems. Tampons can be used normally. Alternatively the piles dressing will act as a sanitary pad. Sleeping You will be offered painkillers rather than sleeping pills to help you to sleep. If you cannot sleep despite the painkillers please let the nurses know. The wound The wound may have a dressing held on with mesh elastic pants. There may be some staining with blood during the first 12 hours. If you have a dressing it will be removed the day after operation and you may have a bath or shower. After this only a pad need be worn. There may be some purple bruising around the wound which spreads and fades to a yellow colour after 2 to 3 days. It is normal There are threads tied round the stumps of the piles. These will drop off by themselves in 4 to 5 days. This is often accompanied by some bleeding. Any other stitches dissolve. Washing You can wash the wound area as soon as the dressing has been removed. Soap and tap water are entirely adequate. Salted water is not necessary. How long in hospital? This varies from same day discharge to 2 to 3 days Drinking and eating You will be able to drink within an hour or two of the operation provided you are not feeling sick. The next day you should be able to manage a normal diet. Sick notes Please ask the doctor for sick notes, certificates etc. After you leave hospital You may be uncomfortable for 3 or 4 days. The wound should heal within 3 weeks. You will be given laxatives and painkillers to take home. Use them! Driving You can drive as soon as you are comfortable and can drive safely. Usually after 4 or 5 days. What about sex? You can restart sexual activities as soon as you are comfortable. Work You should be able to return to work within two weeks. Complications Complications are rare and seldom serious. The wound is always a bit moist for a week or two. There is likely to be a discharge of yellow matter and even some dark blood on the dressings during this time. Opening your bowels becomes rapidly easier particularly if you take a laxative. Occasionally you may notice difficulty controlling the wind through your back passage. This improves after a day or two. The chance of the piles coming back again is small. It is increased by a constipated bowel habit and straining. GENERAL ADVICE In general the operation is much less painful and troublesome than friends and acquaintances would lead you to believe. It will, however, be several weeks before the wound settles down completely. If you have any problems or queries, please ask the nurses or doctors. |
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