The polyp cannot be left
Polyps are often discovered during examination for hemorrhoids - they are detected during anoscopy or sigmoidoscopy. It is not advisable to leave the polyp during surgery: it can bleed, and some adenomatous polyps eventually degenerate into a malignant tumor. Removal during the same intervention does not significantly prolong anesthesia, and the removed material is necessarily sent for histological examination - it is this that determines the need for further observation.
When should hemorrhoids be operated on?
Conservative treatment - suppositories, ointments, phlebotonics - is effective in the first and second stages, when the nodes do not fall out or correct themselves. It relieves aggravation, but does not remove already formed nodes.
In the third and fourth stages, when the nodes fall out and do not reset on their own, with repeated bleeding with anemia and thrombosis, surgery remains a radical solution.
What are they often doing at the same time?
In a significant proportion of patients, hemorrhoids are combined with an anal fissure or anal polyp. It is irrational to eliminate them with separate operations: this is a second anesthesia and a second recovery period. Therefore, interventions are often combined—in one operation, nodes are removed and a fissure or polyp is excised at the same time.
Recovery
The most sensitive period is the first 7–10 days, especially the first bowel movements. The key condition for a smooth recovery is soft stools: a laxative diet, sufficient fluids and, if necessary, laxatives are prescribed. It is strictly forbidden to push during this period.