I think you wouldn't need surgery once you get properly treated. I think problem is you have never been properly diagnosed by a doctor and you have self diagnosed it as piles eventhough I think it could be **** fissure or rectal prolapse or anything and nothing can be told without examination.
Please STOP using herbal medicine. You never know what's in them and especially many of them contain steroids. For swelling steroid creams can be used but this can be only be prescribed by a general surgeon after examination. Because steroid creams if overused can cause many side effects.
So my advice to you first of all visit a general surgeon or gastroenterologist he will examine you and then tell whether you even have piles/hemorrhoids or not. Any surgeon or gastroenterologist will NEVER immediately advise you to go for surgery first of all they will always try to reduce it medically if it is not controlled then surgery is the last option which we have rarely seen being done. Most piles disappear medically, go to a gastroenterologist instead if you are afraid of a surgeon an excellent gastroenterologist is at shifa international Dr. Saeed Zamir.
PLEASE don't be embarrassed about anything it's not your fault it's a disease like every other disease be it flu, heart attack or anyone you can think of. Tell the elders "you are suspecting you have bawasir(piles urdu name) but as you are not sure about it and only a doctor can tell after examination what the problem is so I need to visit a gastroenterologist so that he can examine and tell for sure what it is and can treat it before it develops any complications."
Old people commonly develop prostate and constipation problems for which they visit doctors, do they get embarrassed and don't go to a doctor, NO they do go to a doctor as they are in trouble and pain. So kindly try to ease out your problem by visiting a specialist.
Surgery as I said you do not require for now but if required will cost 20000 to 40000 max depends on the qualification of surgeon.
