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Hemorrhoidectomy

 

ID: 050404323

Science Topic

Hemorrhoidectomy

Surgical Removal of Hemorrhoids

Education Center | Course ID: 050404323

Publication Details

Author: Finn Vortex

Published: 04 December 2025

Updated: 04 December 2024

Duration: 0 Minutes

Executive Summary

General overview of surgical removal of severe hemorrhoids, including information on selecting this hemorrhoidal treatment and surgeon, procedure details, recovery and rehabilitation, and mental/emotional considerations associated with the surgery and surgical outcomes.

Overview

A hemorrhoidectomy is a surgical procedure that is used remove hemorrhoids that have become too large or problematic to treat with diet and lifestyle changes, pharmaceutical treatments, and non-surgical outpatient procedures.

VOCABULARY

hemorrhoidectomy

  1. Noun Surgery to remove internal or external hemorrhoids that are extensive or severe.

There are different types of hemorrhoidectomies, with the most common being traditional excisional surgery, laser excision, and stapled hemorrhoidopexy. The type of surgery selected will depend on the severity and location of the hemorrhoids.

Hemorrhoidectomy may become necessary if you experience:

  • Severe and persistent pain that doesn’t respond to other treatments.
  • Bleeding that doesn’t stop or keeps recurring.
  • Prolapsed hemorrhoids that protrude from the anus and cause discomfort.
  • Chronic thrombosis (blood clots) that don’t resolve on their own.
Prolasped Stage IV Hemorrhoid
Figure 1.1: Prolapsed Grade IV Hemorrhoid

Grade IV hemorrhoids constantly prolapse from the anus and are unlikely to stay within the body when pushed in manually.

Surgery is often the last and only effective option for heavily symptomatic Grade III and IV hemorrhoids. Fisters with these grades of hemorrhoids may experience pain, bleeding, bowel incontinence, and difficulty sitting, douching and bottoming. If possible, fisters should seek the care of a proctologist before reaching Grade III and IV to allow for less invasive treatments.

Procedure

Risk and Complications

Like any surgery, hemorrhoidectomy carries risks, including:

  • Infection | As with any surgical procedure, there is a risk of infection.
  • Bleeding | Some bleeding may occur after surgery, though it typically stops within a few days.
  • Diminished Sexual Ability | Fibrosis (scarring) and anal stenosis (narrowing of the hole) are not uncommon. Fisting can become difficult and painful.
VOCABULARY

Fibrosis

  1. Noun The development of excess fibrous connective tissue. Synonym: Scarring.

Stenosis

  1. Noun A narrowing or stricture of a passage or vessel.

Preparation

Specific instructions are provided on how to prepare for the procedure, including:

  • Dietary Adjustments | A light diet the day or two before surgery helps ensure the bowels are clear.
  • Medications | Some medications, like blood thinners, may need to be stopped before surgery to reduce the risk of excessive bleeding.
  • Lifestyle Changes | Avoiding constipation and remaining properly hydrated helps prevent complications during recovery.
  • Abstinence | Fisting within the weeks prior to surgery can cause significant swelling inflammation and decrease surgery success rates as well increase complications such as fibrosis and stenosis.
Abstain From Play Overlay Image
Figure 2.1: Restricted Behavior Prior to Surgery

@Fred_FFoster demonstrates elementary technique. To prevent flare-ups before surgery, abstain from all fisting and penetration activity.

Surgery

Most non-invasive hemorrhoidal procedures for Grade I and II hemorrhoids are completed on an outpatient basis. A hemorrhoidectomy is usually done in a surgery center or a specific outpatient department inside a hospital where general anesthesia can be given or where an overnight stay may be necessary.

The size and scope of the hemorrhoids may determine if the anesthesia is local or general, typically general anesthesia is used. The surgery lasts between 30 to 60 minutes.

Stapled hemorrhoidectomy / Hemorrhoidopexy[1]YouTube Logo

Post-op Care

Immediately after surgery that is performed within a surgery center or hospital outpatient services area, you will be monitored by nursing staff until you recover from general anesthesia. You will be allowed to rest in a semi-private area with other patients nearby. Staff will monitor your vitals and check for excessive bleeding before discharging you. Most fisters are able to return home without an overnight stay.

Surgeries without complications will result in discharge after vitals have stabilized and a few hours of observation are completed.

A friend, family member, or uber will need to take you home upon discharge.

Post Surgery Recovery Bay
Figure 2.2: Recovery Bays in Surgical Center

After surgery, nurses will monitor you in a large room with several other patients until you are ready for discharge.

Recovery

Follow-up Care

The hospital, surgery center, or the surgeon's staff will follow up regularly over the next few days. You will meet with your surgeon or proctologist within a week to monitor the healing process and then less regularly after that until discharged from care. If you have significant bleeding, report to the emergency room immediately.

Post Surgery Recovery Bay
Figure 3.1: Post-surgical Care Schedule

Post-surgical care has several contact points. Sexual activity can be discussed at any point but may be more appropriate at the two week or two-month follow-up visit.

Pain Management

Pain after surgery is significant. Pain management is a critical part of the recovery process. In the first few days following surgery, there will be some pain, swelling, and even light bleeding. These symptoms are common and manageable with:

  • Pain Relievers | Non-steroidal anti-inflammatory drugs (NSAIDs) or prescription medications.
  • Sitz baths | Soaking in warm water several times a day to reduce discomfort.
  • Ice packs | Exposure to cold minimizes swelling and pain in the anal area.

After a few days, the intense pain will reside, but you may need to continue with the aforementioned options for two weeks.

Hemorrhoidal Ice Packs
Figure 3.2: Hemorrhoidal Cold Packs

One method for decreasing post-surgical pain is special ice packs designed to cradle the anus. Medications and sitz baths can also help alleviate pain.

Lifestyle Adjustments

Many fisters will have already made lifestyle adjustments if they have a history of Grade III or IV hemorrhoids. Diet, clothing choices, and sexual activity may all be affected during the recovery period.

Clothing / Attire

For the first few days after surgery, many patients opt to wear protective undergarments or pads to address bleeding issues. At night, they may use puppy pads or chucks to protect bedding.

Diaper / Depends
Figure 3.3: Depends on Your Preferences

Depends undergarments or ABDL diapers may be used to prevent blood from staining clothing, bedding, or furniture.

Diet

Eating a high-fiber diet, drinking plenty of fluids, and avoiding constipation will help ease bowel movements during recovery. Gentle, non-straining bowel movements are key to preventing complications and further irritation of the surgical site.

QUICK REFERENCE

Special vitamins and supplements can be taken to decrease fibrosis and the level of stenosis that may occur with a hemorrhoidectomy:

  • Methylsulfonylmethane (MSM) | An organic, sulfur-containing compound that is purported to alleviate joint pain, improve mobility, and repair connective tissues. It can be applied via a cream or taken as a capsule. Note that it interacts with NSAIDs and blood thinners, so you may want to start after all surgical pain dissipates.
  • Serrapeptase | An enzyme created by silkworms said to eat scar tissue and activate normal collagen production.

Abstinence Period

You should avoid any form of anal sex, fisting, or other intense activities for at least 4 to 6 weeks after surgery, or as advised by your surgeon. When you do resume sexual activity, start slowly and communicate openly with your partner about your healing process.

Abstinence Period
Figure 3.4: Strict Adherence to Abstinence

Surgeons recommend a specific abstinence period that when followed, prevents delayed healing, relapses, or additional surgeries.

Hole Reconditioning

A hemorrhoidectomy will relieve medical issues related to a hemorrhoidal plexus prolapse, but it will also narrow your hole and decrease its ability to stretch. The hole can be rehabilitated over time, but it is important to go slow and listen to your body during your reconditioning. Resuming fisting and anal sex too soon can lead to complications including relapse.

Time Frame / Schedule

Allow a minimum of six weeks before you begin rehabilitation activities. Waiting a few extra months is even better. You may need to seek psychological therapy to address the mental distress experienced when losing part of your sexual identity, see Psychosocial Considerations.

Allow at least six weeks from your surgery before inserting any object into your hole.

Starting play prior to proper healing may result in the return of hemorrhoids at a more severe grade. You may irreparably damage your hole and prevent future fisting.

While in recovery, take time to reconsider your sexual identity. You may need to rewire your thoughts and examine fisting in a different light.

For example, if fisting has always been a BDSM behavior for you and punch fisting has been your primary fisting activity, you may need to learn about power structures and dominance; versatility and topping; and other types of play such as elementary and depth fisting.

During your abstinence period, take the opportunity to improve your topping skills. If topping is anathema to you, consider working on non-hole related skills, such as body flexibility and breathing.

Recovery Time
Figure 3.5: Rehabilitation Time

Hole rehabilitation can take up to a year or more before recovering all former abilities. Some abilities may never return.

After your abstinence period ends and your reconditioning begins, you can expect at least a year of rehabilitation before you are able to comfortably fist again.

Nutritional Supplements

Most hemorrhoidectomies result in significant damage to the stretch capacity of your hole. There are some nutritional supplements that can decrease the fibrotic tissue that has led to anal stenosis. See Lifestyle Adjustments | Diet.

Lubrication

A hemorrhoidectomy results in tissue damage, specifically to mucous membranes and sphincter within the anal canal. Base-coating helps protect the mucus membranes you still have and coats fibrotic tissue, decreasing the likelihood of reopening scar tissue.

Methodology

Reconditioning involves gradual stretching over time to recover lost abilities. Unless you have a patient top that can work with you a couple times a week and not expect full penetration for several months, your best option for speedy recovery is toy play.

While there are hundreds and hundreds of toys sold by various vendors, SquarePegToys offers the best rehabilitation toys on the market for the following reasons:

  • Form and Function | The owner of SquarePegToys is its Chief Creative Officer and a skilled fister. He personally designs all of the toys. A large portion of the SquarePegToys catalog is ergonomically designed—factoring in safety, efficiency, and comfort.
  • Firmness | The base firmness of SquarePegToys is appropriate for damaged and undamaged holes alike. It is trademarked "supersoft" and many knockoff vendors try to emulate this firmness, without understanding the design and form of butt toys.
  • Texture | A classic characteristic of most SquarePegToys is a super sleek texture. Highly textured toys are not good for rehabilitative activities.
  • Material | SquarePegToys are made of high-grade Platinum-cured Silicone. Many vendors use substandard silicone and curing methods to save money. These substandard materials can irritate and burn the hole.
The Egg
The Slim
The Squirm
The Anaconda
Figure 3.6 [A - D]: Ideal Toys for Hole Rehabilitation

[A] Small Egg plugs test abilities and start rehabilitation. [B] Longer, skinny toys such as the Slim help the scarred hole get accustomed to pressure and touch. [C - D] Tapered toys such as the Squirm and Anaconda begin stretching the injured area gradually, as to prevent re-injury to the hole. SquarePegToys are the best toys for recovery due to their design, firmness, and materials.

Rehabilitation Routine

The following is a sample routine for reconditioning your hole. Your goal should be to take a hand at the end of 12 months. Do not push yourself to jump between stages, let stretch capacity occur naturally without force. If at the end of a year, you are still having difficulty, continue the rehabilitation process with gradual increases in toy circumference until you reach your desired outcome.

0-3 Months

Avoid inserting anything into your hole for at least six weeks from your surgery. Sometime between Week 7 and Week 12, insert a lubed finger to gauge the extent of scarring and the difficulty of penetration.

Focus on other activities during this time, such as breathing, yoga, and topping.

Conduct a Fuck Only level douche with a douche bulb instead of using a shower shot for your clean out.

4-6 Months

At the beginning of Month 4, insert the SquarePegToys Egg XS butt plug. Gauge the difficulty, of insertion. If it is painful, use SquarePegToys The Slim every third or fourth day until you can take it completely.

If the Egg XS is too small, consider sizing up in butt plugs until you reach a point of difficulty or pain. If you can take a SquarePegToys Egg XL or a ToppedToys Gapekeeper 8.5, you can begin playing with guys with medium or large collapsible hands.

If you are reluctant to buy multiple butt plugs, use SquarePegToys' The Squirm to gauge your width capacity. If you can bottom out on it, then you can begin bottoming for other men.

Continue using a Fuck Only level douche with a douche bulb instead of using a shower shot for your clean out.

7-9 Months

At Month 7, your goal should be small to large collapsible paws, but with elementary fisting only and for a limited duration session.

Use SquarePegToys The Squirm or Anaconda to increase your girth capacity. The Anaconda has decent girth as you approach the bottom of the toy. If you master it, your rehabilitation is complete.

You may begin non-brutal bottoming with a trusted top that shoots huge loads in your hole without having to fuck you for more than 10 minutes. He should be gentle on your hole to prevent re-injuring it.

If you are having difficulty inserting these toys a couple times a week, consider adding an inflatable dildo to your collection that you will discard within the next 24 months.

Resume normal douching with a shower shot, but make sure your hole and your nozzle are both coated with shortening or petrolatum (Crisco or Vaseline) before use.

10-12 Months

Continue training on the aforementioned toys until you reach a 26.5-centimeter (10.5-inch) circumference insertion without pain or difficulty.

If 26.5 centimeters (10.5 inches) enter without difficulty, you can consider adding textured toys to your routine or abandoning your reconditioning completely. Your hole has been rehabilitated.

If you are finding it difficult to take 21.5 centimeters (8.5 inches) of circumference, then add an inflatable toy to your play routine.

You can start experimenting with textured toys and PVC toys once you are a 26.5-centimeter (10.5-inch) circumference. If textured toys do not cause any pain, you may start punch play with small hands in duck-bill formation (no closed fist).

Douche with a shower shot after base coating your hole and lubricating the nozzle.

Psychosocial Considerations

Losing the ability to take fists with ease has profound psychosocial implications. This loss impacts emotional well-being, identity, and social relationships. The emotional and psychological toll can vary depending on a fister’s coping mechanisms and support systems. It often involves stages of grief, identity crisis, anxiety, and depression.

After having a hemorrhoidectomy and losing the ability to bottom, a fister may experience:

  • Loss of Identity and Role Confusion | For a fisting bottom, his hole's ability is deeply intertwined with his sense of self. Losing the ability to bottom leads to feelings of disorientation, questioning purpose, and even a loss of self-worth.
  • Grief and Mourning | Even before fully coming to terms with the loss, a bottom may experience grief about the fisting experiences he expected to have. He may be angry or in denial about surgical outcomes and side-effects. That anger may be mixed with sadness over the loss of a skill he has honed for years or decades.
  • Depression and Anxiety | If a bottom no longer feels that he has a purpose or that his hole's abilities are potentially lost for good, he will experience depression. This may manifest as feelings of hopelessness, worthlessness, or even suicidal ideation, especially if he feels isolated because close family and friends are unaware of his fisting proclivities. The future may seem uncertain and frightening. Anxiety can arise from fears about not being able to bottom and whether he can find a new way to relate sexually to other men.
  • Rehabilitation Challenges | A bottom will attempt hole rehabilitation which can be discouraging and emotionally challenging. He will struggle with frustration over his hole's inability to function as it once did. In some cases, he might develop topping skills, but this can take time and often increases his personal grief over lost abilities.
  • Loss of Relationships | Relationships with tops or versatile fisting partners may dissipate. With the loss of his identity as a Bottom or Power Fister, he may withdraw due to grief and depression. Both fisting and non-fisting relationships may suffer.
  • Perceived Worth | A bottom may feel that he is invisible or irrelevant within the fisting community after surgery. Losing the ability to bottom may lead him to feel inadequate or worthless, as he no longer feels he can contribute in the same way he previously did.

Counseling or therapy can help a bottom process the psychological impact of the loss. Therapy might help with grieving, developing coping strategies, and re-establishing a new sense of identity. Connecting with others who have experienced a loss of bottom identity may reduce fear of the unknown and feelings of isolation.

Content Development

The following material is under consideration in the development of this topic:

Objectives

Upon completing this course, the student will be able to:

  • List four reasons why a hemorrhoidectomy may be necessary
  • List two complications from a hemorrhoidectomy that affect your bottoming abilities
  • Identify two supplements that may decrease scarring and return some elasticity to the hole
  • Identify at least one toy that may help in hole reconditioning
  • Explain with at least two specific reasons why a bottom may have mental/psychological issues after having a hemorrhoidectomy.

Note: Objectives should follow instructional design standards and be easily measurable with little ambiguity.

Supplemental Content

Blog Articles

  • Blog Article #1
  • Blog Article #2

F2 Promotional Materials

  • Thursday Erotica/Neurotica: None
  • Skills: None
  • Protocols: None
  • FWOTD:
    • Hemorrhoidectomy

Outline (Proposed)

  • Overview
  • Procedure
  • Risk and Complications
  • Preparation
  • Surgery
  • Post Op Care
  • Sub Heading
  • Sub Heading
  • Sub Heading
  • Sub Heading
  • Recovery
  • Follow-up Care
  • Pain Management
  • Lifestyle Adjustments
  • Clothing / Attire
  • Diet
  • Hole Reconditioning
  • Time Frame / Schedule
  • Nutritional Supplements
  • Lubrication
  • Methodology
  • Psychosocial Considerations

F2 Resources

These individuals have indicated they continue fisting with this condition:

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