Are surgery necessary to remove hemorrhoids?

Not always. There are surgical options for hemorrhoid removal, but that is not always necessary. More conservative treatments such as medicated creams, suppositories and sitz baths can sometimes assist in the shrinkage of hemorrhoids to the point where they are smaller and not bothersome.
Usually Not. There are a number of highly-effective, well-tolerated non-surgical procedures now available to treat internal hemorrhoids, such as infrared coagulation, ultroid, and rubber band ligation. The classic hemorrhoid surgery is now generally reserved only for the most advanced cases of hemorrhoids, or those that do not respond adequately to office-based procedures.