What to Expect During Your PPH – Step by Step

It’s called a stapled hemorrhoidectomy, and it’s one of the leading surgical procedures performed today for the treatment of hemorrhoids. Also known as Procedure for Prolapse & Hemorrhoids (PPH), calling this treatment a stapled hemorrhoidectomy is misleading. This procedure does not completely remove the inflamed hemorrhoidal tissue like a traditional hemorrhoidectomy.

Instead, it removes a band of ruptured elastic tissue that has allowed the hemorrhoids to prolapse and even emerge out the anus in some cases. Then, staples cut off the blood supply to the inflamed piles. They shrink back down to size and are repositioned to a normal location in the anal canal.

Although PPH is sometimes used to treat symptomatic second degree hemorrhoids, it is usually used to relieve the immense irritation and pain associated with third and fourth degree piles. If you are currently experiencing intense symptoms from your hemorrhoids, you will likely experience almost immediate relief following your PPH.

Preparing for your PPH Surgery

Simple enemas are used to clean the anal canal in preparation for the procedure.

Your surgeon may also advise you to stop taking blood thinners one week prior to your PPH. Aspirin, and other drug may increase bleeding if they are not stopped   Do not do this unless your doctor instructs you to, however. Stopping this type of medication may increase your risk of heart attack or stroke, so it is paramount you discuss your options with your surgeon and your primary care physician.

In most cases, you will not be allowed anything to eat or drink – including water – after midnight the night before the procedure.

Undergoing a Procedure for Prolapse and Hemorrhoids

When it comes time for the PPH surgery itself, you will likely be under anesthesia for the entire process. Once the anesthesiologist administers the medication, we will position your body for the best access. We may use two surgeons in the operating room during this procedure, and the whole thing takes only about 30 to 45 minutes.

During the operation, the surgeon will inspect the anal canal, carefully insert the PPH instrument and perform the operation.

Recovery After a PPH Procedure

Patients usually return home quickly after undergoing PPH surgery. Depending on how long it takes you to wake up, often our patients are home resting within an hour or two of their procedure. We encourage you to return to a high fiber diet rich in fruits and vegetables as soon as possible after the procedure. Preventing complications – and further issues with hemorrhoids – requires you to have normal bowel movements on a regular basis.

PPH is typically a much easier process for patients than a traditional hemorrhoidectomy. Patients report much less pain than a traditional surgery. The top complaint is that patients often feel a need to defecate or other pressure inside the rectum in the first hours or days following PPH. This usually goes away on its own quickly.

After you heal from your procedure, your surgeon will most likely want to discuss how you can prevent a hemorrhoidal recurrence.   A few lifestyle changes such as a better diet and regular exercise can dramatically cut your risk of a recurrence. If you do not make changes, you run the risk of developing piles again. And the next time, your hemorrhoids might be worse and you may need a more invasive procedure.