Does anyone know what the indications are when a hemorrhoidectomy is recommended?
I have an external partially thrombosed hem, have had two thrombosed hems incised before (clot removed) in docs office over the last several years. Also had surgery about ten years ago due to a fissure. Have skin tags.

What makes doc say "I recommend a hemorrhoidectomy" vs "This can be taken care of easily right in my office" (as was done with the last two I had). Does anyone know? Thank you!!!!!