Post-Surgery Anal Wound: Pain and Complications

Wound near the anal opening after hemorrhoid surgery?

After surgery, the skin wound around the anal area initially showed signs of healing with granulation tissue formation.
However, starting from the third week post-operation, there has been occasional bleeding during urination and bowel movements, although the amount is minimal.
Additionally, two protruding masses have appeared, which are painful.
Could you please clarify what the issue might be? Will these protruding masses disappear? There are also moments when there is a sensation of wanting to tighten the anal area, similar to the feeling experienced with hemorrhoids, as if they are trying to protrude.
Could this be due to straining during bowel movements on the second day post-surgery, leading to the development of new hemorrhoids, or is it related to the healing process of the wound? Now, nearly a month post-surgery, the pain from the external wound seems to be more pronounced than that from the internal wound.
Is this normal? I apologize for the lengthy inquiry, and thank you for your assistance.

Xiao Bao, 30~39 year old female. Ask Date: 2017/10/29

Dr. Ke Fangxu reply Surgery

After hemorrhoid surgery, there may sometimes be the occurrence of anal tags.
If there is no pain or bleeding, it can be ignored.
However, it is common to experience some bleeding and pain within the first month after surgery.
It is recommended to monitor the situation for another week or two.
If the symptoms persist without improvement, it is advisable to consult the surgeon for further evaluation.

Reply Date: 2017/10/29

More Info

Post-surgery complications, particularly concerning anal wounds, can be a source of significant discomfort and concern for patients. Based on your description, it seems that you are experiencing a few issues following your surgery, including pain, bleeding during bowel movements, and the presence of protruding tissue or "bumps" around the anal area. Let's break down these symptoms and discuss their implications.

Firstly, it is not uncommon for patients to experience some degree of pain and discomfort after anal surgery. The healing process can be quite sensitive, and the anal region is particularly prone to irritation due to its function and the nature of bowel movements. The fact that you initially noticed some healing tissue is a positive sign, indicating that your body is attempting to repair itself. However, the emergence of bleeding and pain, especially when associated with bowel movements, raises some concerns.

The bleeding you are experiencing could be attributed to several factors. One possibility is that the surgical site is still healing, and straining during bowel movements can disrupt the healing tissue, leading to minor bleeding. This is especially true if you are experiencing constipation or if your stools are hard, as straining can exacerbate the situation. It is crucial to maintain a diet high in fiber and to stay well-hydrated to promote softer stools and reduce the need for straining.

The "bumps" you mentioned could potentially be hemorrhoids, which are swollen veins in the rectal area that can develop after surgery, especially if there has been significant straining. They can cause discomfort, pain, and sometimes bleeding. If these bumps are indeed hemorrhoids, they may resolve on their own with proper care, including dietary adjustments, topical treatments, and possibly sitz baths to soothe the area.

However, if the pain persists or worsens, or if you notice significant changes in the bleeding (such as increased volume or changes in color), it is essential to consult your healthcare provider. They may want to examine the area to rule out any complications such as infection, abscess formation, or other issues that could require intervention.

Regarding your concern about the pain being more pronounced at the external site compared to the internal site, this can also be a normal part of the healing process. The external area may be more sensitive due to exposure and movement during daily activities. As healing progresses, you may find that the pain diminishes over time. However, if it continues to be a significant issue, further evaluation may be warranted.

In summary, while some pain and discomfort post-surgery are expected, the presence of bleeding and new growths should be monitored closely. Maintaining a healthy diet, avoiding straining, and consulting with your healthcare provider for any persistent or worsening symptoms are crucial steps in ensuring a smooth recovery. Your healthcare provider can offer tailored advice and treatment options based on your specific situation, so do not hesitate to reach out to them for guidance.

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