Evidence‐Based Strategies for Post‐Hemorrhoidectomy Pain Management: A Systematic Review

Post‐hemorrhoidectomy pain is one of the most common and distressing complications following hemorrhoid surgery, which can significantly affect patients' quality of life, recovery duration and analgesic consumption. Despite advancements in surgical techniques and postoperative care, there is still no standardised and integrated approach for effective pain control. The aim of this study was to systematically review the existing evidence regarding strategies for reducing pain after hemorrhoidectomy. This study was conducted as a systematic review in accordance with the PRISMA guidelines. A comprehensive search was performed in PubMed, Scopus, Web of Science, Magiran and SID databases for articles published between 2000 and 2025. Primary research articles investigating post‐hemorrhoidectomy pain and interventions for its reduction were included. Study quality was assessed using the CASP tool. After removal of duplicates and screening, 47 eligible articles were included in the final analysis. The findings indicated that pain intensity following hemorrhoidectomy is moderate to severe in most patients during the first 24–72 h. Pharmacological interventions, including nonsteroidal anti‐inflammatory drugs (NSAIDs), topical anaesthetics, and structured multimodal regimens, were effective in reducing pain severity and opioid consumption. Minimally invasive surgical techniques and closed hemorrhoidectomy were associated with less postoperative pain and faster recovery compared with traditional open methods. Supportive interventions such as early sitz bath and cryotherapy were also reported to reduce pain, particularly when combined with pharmacological treatments. However, heterogeneity in study design and pain assessment tools was observed. Effective management of post‐hemorrhoidectomy pain requires a multidimensional and combined approach. The concurrent use of appropriate surgical techniques, structured pharmacological regimens and supportive care measures can reduce pain, accelerate recovery and improve patient satisfaction. High‐quality studies and the development of evidence‐based clinical guidelines are necessary for standardising pain management.