Post-Surgery Wound Inflammation: Complications After Sexual Activity

Postoperative wound inflammation and suppuration due to fecal contamination?

Hello, doctor! It has been 40 days since my surgery.
I have a complex fistula with four wounds.
Initially, all four were healing well, but after engaging in sexual intercourse, I noticed inflammation and swelling around the wounds and the anal area during bowel movements.
Subsequently, the wounds have shown some brown, viscous discharge that may be pus or feces.
My questions are: 1.
The wounds did not have this issue before; could this be related to sexual intercourse? 2.
During a follow-up visit, the doctor mentioned "gold foil over silver" and suggested puncturing the wound to allow pus and blood to drain.
Is this the only option? 3.
Why has there been no fecal matter in the wounds for 40 days post-surgery, and why is this issue arising now?

Pipi Xia, 20~29 year old female. Ask Date: 2016/10/11

Dr. Ke Fangxu reply Surgery

1.
There should be no relation; complex fistulas typically have a more difficult healing process.

2.
It is likely an infection of the wound or a recurrence of the fistula, which may require another surgery for a complete cure.

3.
This question is best directed to the surgeon who performed your procedure, as it is often caused by wound dehiscence or incomplete cleaning.

Reply Date: 2016/10/11

More Info

Post-surgery complications, especially in the context of complex anal fistula repairs, can be concerning and require careful management. Your situation, involving inflammation and discharge from the surgical site after engaging in sexual activity, raises several important questions that need to be addressed.

1. Is the inflammation related to sexual activity?
Yes, it is possible that the sexual activity contributed to the inflammation you are experiencing. After surgery, the tissues around the surgical site are still healing and can be sensitive. Engaging in sexual activity can introduce additional stress to the area, potentially leading to irritation or trauma. This can result in inflammation, swelling, and even the formation of discharge if the area becomes infected or if there is an accumulation of fluid. It is crucial to allow adequate time for healing before resuming sexual activity, as the tissues need to regain their strength and integrity.

2. Is it necessary to puncture the wound to allow drainage?
The recommendation from your physician to create an opening for drainage may be necessary if there is a significant accumulation of pus or fluid that is not resolving on its own. This procedure, often referred to as incision and drainage, can help alleviate pressure and promote healing by allowing any trapped fluid to escape. However, this decision should be made by a qualified healthcare professional after a thorough examination. It is important to follow your doctor's advice, as they can assess the situation and determine the best course of action based on the specifics of your case.

3. Why is there now a problem with bowel movements when there were none before?
The appearance of issues with bowel movements after 40 days of healing could be attributed to several factors. First, the healing process can be unpredictable, and sometimes complications arise later in the recovery phase. The inflammation you are experiencing may have altered the normal function of the surrounding tissues, leading to discomfort during bowel movements. Additionally, if there is any residual infection or irritation from the sexual activity, it could exacerbate these symptoms. It is also possible that the increased pressure from bowel movements could have caused irritation to the healing tissues, leading to the symptoms you are now experiencing.

Recommendations for Management:
- Avoid Sexual Activity: Until you have fully healed and received clearance from your healthcare provider, it is advisable to refrain from sexual activity. This will help prevent further irritation and allow the tissues to recover.

- Follow-Up Care: Ensure that you attend all follow-up appointments with your surgeon or healthcare provider. They can monitor your healing progress and address any complications that arise.

- Wound Care: Maintain proper hygiene around the surgical site. Gentle cleaning with mild soap and water can help prevent infection. Avoid any harsh chemicals or scrubbing that could irritate the area.

- Monitor Symptoms: Keep track of any changes in your symptoms, such as increased pain, swelling, or changes in the discharge. If you notice worsening symptoms, contact your healthcare provider promptly.

- Dietary Considerations: To ease bowel movements, consider a diet high in fiber and adequate hydration. This can help prevent straining during bowel movements, which can further irritate the surgical site.

In conclusion, while complications after surgery can be distressing, they are not uncommon, especially in complex cases like anal fistula repairs. It is essential to communicate openly with your healthcare provider about your symptoms and follow their recommendations for care and recovery. Your health and well-being should be the priority, and taking the necessary steps to ensure proper healing will help you return to normal activities, including sexual activity, in the future.

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