La clinique Bremen-Ost est reconnue comme l'un des meilleurs établissements médicaux d'Allemagne avec des taux de réussite de traitement élevés. Une hémorroïdectomie peut coûter environ 2 900 à 3 600 $. Le professeur Rainer Porschen, gastro-entérologue hautement qualifié avec _doctor_564_years_ d'expérience, est spécialisé dans les traitements gastro-intestinaux et a contribué aux directives allemandes pour le traitement du cancer de l'œsophage.
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Il est certifié par la Société européenne de coloproctologie (FEBS-C) et a réalisé plus de 500 interventions de chirurgie bariatrique.","linkedin":"","specialities":[{"id":"sur.006","name":"Colorectal surgeon","illness_kind_id":33},{"id":"sur.010","name":"General surgeon","illness_kind_id":33}]},"direction":{"id":33,"name":"Chirurgie","alias":"surgery"},"illness_kind":{"id":33,"name":{"en":"Surgery"}},"parsed_details":{"procedure_type":"surgery","fields":{"anesthesia":["general"],"back_to_work_days":{"min":7,"max":21,"unit":"days","qualifier":"Desk-based work after conventional excisional hemorrhoidectomy; manual work may need longer."},"complication_rate_pct":{"min":1,"max":5,"unit":"percent","qualifier":"Major events: secondary hemorrhage needing readmission, transfusion or reoperation, abscess or sepsis, symptomatic stenosis. Excludes minor events. Grade III–IV hemorrhoids."},"contraindications":["Uncontrolled bleeding disorder or unmanageable therapeutic anticoagulation","Active anorectal sepsis or severe perianal infection (relative)","Severe uncontrolled cardiopulmonary disease making anesthesia unsafe","Active severe inflammatory bowel disease with anorectal involvement (relative)","Anorectal malignancy requiring different management","Pregnancy (relative; usually managed conservatively)","Poor baseline continence (relative precaution)"],"days_in_clinic":{"min":0,"max":1,"unit":"nights","qualifier":"Typically day surgery or one night of observation for conventional excisional hemorrhoidectomy."},"diagnostic_duration_minutes":null,"diagnostic_preparation":null,"diagnostic_referral_needed":null,"diagnostic_result_time_hours":null,"exercise_resume_weeks":{"min":2,"max":4,"unit":"weeks","qualifier":"Walking earlier; strenuous exercise and heavy lifting after 2–4 weeks."},"final_result_months":{"min":1,"max":2,"unit":"months","qualifier":"Complete wound healing and resolution of swelling after conventional hemorrhoidectomy."},"fly_home_after_days":{"min":7,"max":14,"unit":"days","qualifier":"Delayed bleeding peaks around days 5–14. Fly after the 7–14 day check, once sitting is comfortable."},"follow_up_visits":[{"purpose":"wound_check","requirement":"routine","after":{"min":7,"max":14,"unit":"days","qualifier":"First postoperative review, typically 1–2 weeks after surgery."}},{"purpose":"assessment","requirement":"routine","after":{"min":42,"max":60,"unit":"days","qualifier":"Final review of healing, bowel function and symptoms."}}],"indications":["Symptomatic grade III–IV internal hemorrhoids","Grade II hemorrhoids failing conservative or office-based treatment","Combined internal and external hemorrhoids with prolapse","Thrombosed or strangulated hemorrhoids in selected cases","Recurrent bleeding causing anemia"],"main_risks":["Significant postoperative pain","Urinary retention","Bleeding, including delayed bleeding","Infection or abscess","Constipation or fecal impaction","Anal stenosis","Temporary or permanent incontinence (flatus/stool/soiling)","Skin tags or recurrence","Anesthesia-related risks"],"pain":"Moderate to severe pain for the first several days, especially with bowel movements, gradually improving over 1–2 weeks; managed with multimodal analgesia, stool softeners and sitz baths.","preparation":["Surgical and anorectal assessment, sometimes colonoscopy by age and symptoms","Routine anesthesia assessment and blood tests as indicated","Review of medicines with the surgical team","Fasting before general anesthesia as instructed","Rectal enema or bowel preparation as advised","Arrange transport and adult support after discharge","Dietary fiber and stool softening plan"],"recovery_timeline":[{"phase":"First 48 hours","description":"Recovery from anesthesia, pain control, first bowel movement management, and monitoring for urinary retention and bleeding.","restrictions":["No driving","Avoid straining","Rest"]},{"phase":"Days 3–14","description":"Pain and discharge gradually decrease; sitz baths, fiber and stool softeners continue; light activity resumes and desk work often starts around day 7–14.","restrictions":["Avoid heavy lifting","Avoid prolonged sitting or straining"]},{"phase":"Weeks 2–4","description":"Most return to normal daily activity; mild bleeding or discharge may continue.","restrictions":["Avoid strenuous exercise until cleared"]},{"phase":"Weeks 4–8","description":"Wounds heal fully and bowel habits normalize.","restrictions":[]}],"rehabilitation_days":{"min":5,"max":14,"unit":"days","qualifier":"Time to ordinary activities. Median about 6 days in outpatient series; conventional surgery 1–2 weeks. Energy devices may shorten."},"result_longevity":"Excised hemorrhoids do not regrow, and long-term results are usually durable, though new hemorrhoidal disease can develop, particularly with constipation or straining.","revision_rate_pct":{"min":1,"max":5,"unit":"percent","qualifier":"Repeat surgery for recurrent prolapse, symptoms or stenosis, over about 1–5 years. Symptomatic recurrence is higher (about 5–20%), mostly non-surgical."},"scars":"Healing wounds at the anal canal and perianal skin leave minimal visible scars; small skin tags may remain.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"Single operative session."},"stages":[{"code":"hemorrhoidectomy","label":"Excisional hemorrhoidectomy under anesthesia","after":{"min":0,"max":0,"unit":"days","qualifier":"Performed on the day of surgery."}}],"qualifier":"One operation; follow-up checks are not counted as treatment sessions."},"success":{"metric":"Resolution of bleeding and prolapse symptoms","value":90,"unit":"percent","horizon":"1 year","population":"Adults after excisional hemorrhoidectomy for grade III–IV hemorrhoids","evidence_status":"limited"},"techniques":[{"name":"Conventional excisional hemorrhoidectomy (Milligan-Morgan open / Ferguson closed)","suits_whom":"Grade III–IV or mixed internal-external hemorrhoids","recovery":"Most early pain; usually 1–2 weeks to ordinary activities"},{"name":"Vessel-sealing device hemorrhoidectomy (LigaSure/harmonic)","suits_whom":"Grade III–IV or mixed internal-external hemorrhoids","recovery":"Often slightly less early pain and shorter operating time"}],"treatment_conditions":["day_case"],"treatment_duration_hours":{"min":0.5,"max":1,"unit":"hours","qualifier":"Operating time for one conventional hemorrhoidectomy, excluding anesthesia and recovery."},"initial_assessment_documents":["Colonoscopy or sigmoidoscopy report","Proctology or colorectal clinic consultation notes","List of blood thinners","Recent blood test results","Previous anorectal surgery reports (if available)"],"travel_trips":{"min":1,"max":1,"one_trip_possible":true,"qualifier":"Single operation; stay about 7-14 days until wound check and safe flying. Later reviews can be remote or local."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Ask the surgeon to explain the risks and benefits and to obtain your informed consent before surgery","scope":"procedure","source":{"url":"https://my.clevelandclinic.org/health/procedures/hemorrhoidectomy","host":"my.clevelandclinic.org","quote":"Your surgeon will discuss the risks and benefits of the procedure and obtain your informed consent.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C2","text":"Check that a follow-up appointment is booked a few weeks after the operation","scope":"procedure","source":{"url":"https://my.clevelandclinic.org/health/procedures/hemorrhoidectomy","host":"my.clevelandclinic.org","quote":"Schedule a follow-up appointment with your provider a few weeks after your hemorrhoidectomy.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C3","text":"Check the qualifications of the clinician who will perform the operation","scope":"treatment_abroad","source":{"url":"https://wwwnc.cdc.gov/travel/page/medical-tourism","host":"wwwnc.cdc.gov","quote":"Check the qualifications of the clinician who will be doing the procedure","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C4","text":"Ask whether follow-up care is scheduled at the same facility as the operation","scope":"treatment_abroad","source":{"url":"https://www.cdc.gov/yellow-book/hcp/health-care-abroad/medical-tourism.html","host":"cdc.gov","quote":"Medical tourists should also know whether follow-up care is scheduled to occur at the same facility as the procedure.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":403}},{"id":"C5","text":"Confirm the surgeon is trained and experienced in the exact procedure you are considering, not just in surgery generally","scope":"treatment_abroad","source":{"url":"https://www.isaps.org/discover/patients-home/considering-your-procedure-abroad/finding-a-surgeon-abroad/","host":"isaps.org","quote":"Verify that the surgeon is trained and experienced in performing the procedure you are considering.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"Offers that seem too good to be true are a warning sign in holiday surgery marketing","scope":"treatment_abroad","source":{"url":"https://www.plasticsurgery.org/tourism","host":"plasticsurgery.org","quote":"Just be weary of any deal that seems too good to be true.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"F2","text":"Surgery offered with no consultation with the treating surgeon before the operation","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/conditions/cosmetic-procedures/cosmetic-surgery-abroad/","host":"nhs.uk","quote":"You should have 2 consultations with the surgeon treating you before any surgery.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"F3","text":"An advert or information that guarantees complete success should raise concerns","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Any advert or information that guarantees complete success should raise concerns.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"warning_signs":{"status":"ok","items":[{"id":"W1","text":"Severe pain or bleeding","urgency":"contact_clinic","general":false,"source":{"url":"https://www.mayoclinic.org/diseases-conditions/hemorrhoids/diagnosis-treatment/drc-20360280","host":"mayoclinic.org","quote":"Contact a health professional sooner if you have severe pain or bleeding.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":403}},{"id":"W2","text":"Difficulty urinating","urgency":"contact_clinic","general":false,"source":{"url":"https://www.mayoclinic.org/diseases-conditions/hemorrhoids/diagnosis-treatment/drc-20360280","host":"mayoclinic.org","quote":"Complications can include having a hard time urinating, which can lead to urinary tract infections.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":403}},{"id":"W3","text":"Large amounts of rectal bleeding","urgency":"emergency","general":false,"source":{"url":"https://www.mayoclinic.org/diseases-conditions/hemorrhoids/symptoms-causes/syc-20360268","host":"mayoclinic.org","quote":"Seek emergency care if you have large amounts of rectal bleeding, lightheadedness, dizziness or faintness.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":403}},{"id":"W4","text":"Lightheadedness, dizziness or faintness","urgency":"emergency","general":false,"source":{"url":"https://www.mayoclinic.org/diseases-conditions/hemorrhoids/symptoms-causes/syc-20360268","host":"mayoclinic.org","quote":"Seek emergency care if you have large amounts of rectal bleeding, lightheadedness, dizziness or faintness.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":403}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"take_home":{"status":"ok","items":[{"id":"T1","text":"They specify activities to avoid while the wound heals","document":"activity restrictions","source":{"url":"https://www.royalfree.nhs.uk/patients-and-visitors/patient-information-leaflets/having-a-haemorrhoidectomy","host":"royalfree.nhs.uk","quote":"Avoid heavy lifting or strenuous exercise such as fast running, cycling or horse riding which could be uncomfortable or cause the wound to bleed for 1 week after surgery.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":403}},{"id":"T2","text":"Ask for written details of the procedure before you leave the hospital","document":"written procedure details","source":{"url":"https://rcseng.ac.uk/patient-care/cosmetic-surgery/after-surgery/","host":"rcseng.ac.uk","quote":"After your surgery, before you leave the hospital, ask for written information about the procedure you've had.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T3","text":"Home doctor needs the clinic's follow-up recommendations in a written discharge summary","document":"discharge summary","source":{"url":"https://sbuhb.nhs.wales/about-us/individual-patient-commissioning/ipc-folder/advice-on-accessing-treatment-abroad","host":"sbuhb.nhs.wales","quote":"When you have treatment abroad, you must ask the treatment provider for their follow-up recommendations documented within a written discharge summary in English.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T4","text":"Ask for copies of all prescriptions before you leave","document":"prescription copies","source":{"url":"https://travelhealthpro.org.uk/news/699/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Remember to ask for copies of all your treatment records, including prescriptions, scans and x-rays before you leave.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"alternatives":{"status":"ok","items":[{"id":"A1","text":"Your hemorrhoids do not improve with home treatment","name":"Rubber band ligation","source":{"url":"https://www.healthline.com/health/hemorrhoid-banding","host":"healthline.com","quote":"Hemorrhoid banding, also called rubber band ligation, is a treatment method for hemorrhoids that don't respond to home treatments.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200},"operation_id":null}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"technique_details":{"status":"ok","items":[{"id":"conventional-excisional-hemorrhoidectomy","name":"Conventional excisional hemorrhoidectomy (Milligan-Morgan open / Ferguson closed)","how_it_works":{"text":"Hemorrhoid tissue is cut away with a scalpel or laser","source":{"url":"https://www.healthline.com/health/hemorrhoidectomy","host":"healthline.com","quote":"They'll then cut the hemorrhoidal tissue with a scalpel or laser and close the wound with dissolvable sutures.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},"recovery_daily":{"event":"back_to_daily_activities","min":1,"max":2,"unit":"weeks","label":"1–2 weeks","source":{"url":"https://www.healthline.com/health/hemorrhoidectomy","host":"healthline.com","quote":"Recovery is different for everyone, but you should be able to return to normal activities within 1 to 2 weeks.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}}},{"id":"vessel-sealing-device-hemorrhoidectomy","name":"Vessel-sealing device hemorrhoidectomy (LigaSure/harmonic)","how_it_works":{"text":"An electrothermal device cuts and seals tissue and blood vessels","source":{"url":"https://my.clevelandclinic.org/health/procedures/hemorrhoidectomy","host":"my.clevelandclinic.org","quote":"More recently, surgeons have begun using an electrothermal device to both cut and seal the tissues and blood vessels.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},"recovery_daily":{"status":"missing","reason":"no_official_source"}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1}}},"hrefLanguages":[{"rel":"alternate","hreflang":"ru","language":"ru","href":"https://ru.bookimed.com/clinics/country=germany/city=bremen/procedure=gemorroidektomiya/"}],"questionsAndAnswers":[],"seoTests":{"thin_content":false,"no_txt_after_3_clinics":false},"offerFilters":{"offer_count":0,"price_filter":{"from":0,"to":0,"avg":0}},"leadsCount":{"leads_count":16},"manualSeo":[],"updatedAt":"2026-11-11T22:13:52.000Z","activeCountries":["TR","ES","DE","TH"],"hasVideoReviewsByContext":true,"hasCriticalApiFallback":false}