Post-Surgery Pain and Swelling: Nerve and Blood Vessel Issues

After surgery to remove a cyst from the groin area, a lump has developed near the anus, and there is a hard structure that feels like a blood vessel (or nerve) which is painful to the touch?

Hello, I have a subcutaneous cyst near the left groin and thigh, which was surgically removed and sutured.
A day or two later, the wound swelled towards the anal direction and was painful to touch.
Ten days later, after the stitches were removed, it still hurt but was no longer swollen.
When I asked the surgeon, he said there was no wound or inflammation in that area and only prescribed anti-inflammatory ointment.
At night, along the side of the wound extending towards the anal area and towards the coccyx, I can feel a painful line (it also hurts when sitting down) which is not present on the opposite side of the anus.
It feels somewhat like a blocked blood vessel (similar to the sensation after having blood drawn and applying too much pressure, resulting in a bruise).
I checked online and found that the internal pudendal artery/nerve passes through the groin area.
Which specialist should I see for this? Thank you, I want to resolve this issue as soon as possible.
I am concerned that during the surgery, a nerve or blood vessel may have been inadvertently cut, leading to microvascular blockage or nerve damage.
(After the surgery, my buttocks and thighs feel numb when sitting.)

luck, 30~39 year old female. Ask Date: 2016/11/22

Dr. Lai Zhaokang reply Neurosurgery

Hello, I recommend that you first return for a follow-up with the original surgeon.
If your issue cannot be resolved, then consider consulting a specialist in the same field at another hospital.

Reply Date: 2016/11/22

More Info

Post-surgery pain and swelling, particularly in the area surrounding the groin and thigh, can be concerning and may stem from various underlying issues. Based on your description, it seems that you are experiencing localized pain and swelling after the removal of a subcutaneous cyst, with additional discomfort radiating towards the rectal area and tailbone. This could be indicative of several potential complications or conditions that may arise post-surgery.

Firstly, it is essential to understand that after any surgical procedure, especially in sensitive areas like the groin, it is common to experience some degree of pain and swelling. This is part of the body’s natural healing process. However, persistent pain, especially if it is localized and associated with swelling, should not be overlooked.

One possibility is that you may be experiencing a hematoma, which is a localized collection of blood outside of blood vessels, often caused by bleeding after surgery. Although your surgeon indicated that there was no visible inflammation or open wound, a hematoma can sometimes develop internally and may not be immediately apparent. The pain you feel when touching the area could be due to the pressure from the hematoma on surrounding tissues.

Another consideration is nerve irritation or damage. The internal pudendal nerve, which you mentioned, runs through the area you described and is responsible for sensation in the genital region. If this nerve was inadvertently affected during surgery, it could lead to pain, tingling, or numbness in the surrounding areas, particularly when sitting or applying pressure. This could explain the discomfort you feel when sitting and the sensation of pain radiating towards the tailbone.

Additionally, the sensation of "blood vessel blockage" that you described could be related to vascular issues, such as thrombosis or venous insufficiency. If a blood vessel was compromised during surgery, it could lead to localized swelling and pain. However, this would typically be accompanied by other symptoms, such as changes in skin color or temperature in the affected area.

Given your symptoms, it is advisable to consult with a specialist who can provide a thorough evaluation. A visit to a vascular surgeon may be appropriate, as they can assess for any vascular complications, including potential blockages or issues with blood flow. Additionally, a consultation with a neurologist may be beneficial to evaluate any nerve-related issues, particularly if you continue to experience numbness or tingling sensations.

In the meantime, managing your pain with over-the-counter analgesics, applying ice to the swollen area, and avoiding activities that exacerbate your discomfort may help. If your symptoms worsen or if you develop new symptoms, such as fever, increased swelling, or significant changes in sensation, you should seek medical attention promptly.

In conclusion, while some discomfort is expected after surgery, persistent pain and swelling warrant further investigation. Consulting with the appropriate specialists will help determine the underlying cause of your symptoms and guide you towards effective treatment options. Remember, your health and comfort are paramount, and addressing these concerns with a healthcare provider is the best course of action.

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