Abstract
Nonoperative hemorrhoid procedures are generally less painful and complicated than operative ones, though surgery is sometimes necessary. Surgeons must understand the risks and complications of all procedures. Most acute anal fissures heal with nonoperative therapy, but surgery is sometimes needed. Lateral internal sphincterotomy offers the highest healing rate but risks continence changes, so sphincter-sparing options should be considered for high-risk patients. Anal abscess management (incision and drainage ± fistula procedure) risks defecatory dysfunction if the cause, location, and complexity are ignored.