Surgical care for piles, fissures and fistulae
Piles, fissures, fistulae and rectal prolapse are assessed in a confidential clinical consultation. Open, stapled, laser and laparoscopic procedures are compared after examination, with attention to pain control, continence and recovery.
Conditions commonly treated
Piles (haemorrhoids), painful anal fissures, fistulae, rectal prolapse and pelvic-floor problems can cause bleeding, pain, discharge or difficulty emptying the bowel. Care begins with a discreet, careful examination to confirm the diagnosis, and then the procedures that fit the anatomy are compared. Continence and long-term healing guide the plan.
Author on benign coloproctology and obstructed defaecation:
Dr Bhukebag has contributed forthcoming chapters on "Rectal Prolapse & Laparoscopic Management" and "Constipation & Obstructed Defaecation Syndrome" for the IAGES Recent Advances in Minimal Access Surgery (Jaypee Brothers, 2027).
Procedures offered
Established surgical techniques are compared after assessing the condition, anatomy and continence risk:
Piles: Stapled & Open Haemorrhoidectomy
Stapled haemorrhoidectomy removes a ring of tissue above the piles and lifts them back into place, for internal piles that come out. Open haemorrhoidectomy removes large external piles, or piles with hard or scarred tissue.
- Stapled haemorrhoidectomy for internal piles that come out
- Open haemorrhoidectomy for large external piles
- Choice based on the type and grade of piles
Anal Fistula: Fistulotomy & Sphincter Repair
Low, simple fistulas are treated with fistulotomy, which opens the tunnel so it heals from the base. For higher or complex tunnels, fistulotomy with sphincter repair opens the tunnel and stitches the divided control muscle back together in the same operation.
- Fistulotomy for low, simple tunnels
- Fistulotomy with sphincter repair for higher, complex tunnels
- Plan based on how much muscle the tunnel crosses
Persistent Anal Fissure: Continence-Aware Surgery
When a fissure remains painful after stool-softening and prescription ointment, surgery may be considered after assessing the sphincter and continence risk.
- Aims to improve pain and healing
- Warm sitz baths and soft stools support healing
- The length of stay depends on the procedure and your progress after treatment
Rectal Prolapse: Ventral Mesh Rectopexy (LVMR)
Ventral mesh rectopexy may suit selected full-thickness prolapse after bowel and pelvic-floor assessment.
- Laparoscopic approach where indicated
- May improve prolapse-related symptoms
- Follow-up planned around your needs
Discuss the right treatment for your symptoms
Book a consultation to review your symptoms and examination findings. If a procedure has been advised, bring the reports for a second opinion; the safest conventional, laser or laparoscopic option depends on the diagnosis.