Post-Surgery Concerns: Recovery After Hemorrhoid Surgery

Postoperative Consultation for Hemorrhoids Surgery

Dear Dr.
Ke,
I underwent minimally invasive surgery for internal and external hemorrhoids on the morning of March 1, 2018.
The hospital informed me that the surgical fee would be NT$30,000, which I agreed to pay after the doctor explained the situation during my outpatient visit at the end of February.
I consented to the surgery to alleviate the ongoing issues of bloody stools and the pain from prolapse.
By noon on March 1, I regained consciousness, but the pain at the surgical site was severe.
The doctor prescribed pain medication, which helped reduce the discomfort.
The doctor also recommended soaking the wound in a medicated bath once an hour, and I followed this advice.
The next day, the doctor said I could be discharged.
After returning home, I took care to avoid any heavy lifting or strenuous activities.
However, I find it strange that as of today, April 6, I have been experiencing a continuous yellow discharge from the anal area.
I have to clean the area several times a day, which has caused significant disruption to my daily life.
Additionally, I noticed a wound on the outside of the anal area.
Is this situation normal? Could you please clarify my concerns, Dr.
Ke? Thank you!

in, 50~59 year old female. Ask Date: 2018/04/06

Dr. Ke Fangxu reply Surgery

According to my knowledge, there are no minimally invasive techniques for hemorrhoid surgery available on the market.
What is often referred to as minimally invasive is typically just an alternative name for two types of surgeries, both of which are usually out-of-pocket expenses.
One method is circumferential excision, which can reduce postoperative pain but has limited effectiveness for external hemorrhoids.
The other method involves the use of a harmonic scalpel or laser coagulation device, which can minimize bleeding, but the surgical wound is still the same size.
If you can still feel the wound externally, it is likely that you underwent the latter procedure.
I have also heard of cases where delayed wound healing occurred after surgery with a harmonic scalpel.
Traditional surgical wounds typically heal in about 2-3 weeks, but your situation may be different.
If there is no bleeding, redness, swelling, or pain at the wound site, you can enhance sitz baths and monitor the healing process.
However, if the wound is not healing or if discharge does not stop, you should consult your surgeon to check for any abnormalities.

Reply Date: 2018/04/06

More Info

After undergoing hemorrhoid surgery, it's common for patients to have concerns about their recovery and any potential complications. Based on your description, it seems you had a minimally invasive procedure for internal and external hemorrhoids, which is generally associated with a quicker recovery time compared to traditional surgery. However, the presence of persistent yellow discharge and discomfort can be concerning.

Firstly, it's important to understand that some degree of pain and discharge can be normal after hemorrhoid surgery. The surgery involves cutting away the hemorrhoidal tissue, which can lead to inflammation and healing processes that may produce discharge. However, the nature and duration of this discharge are crucial in determining whether it is a normal part of recovery or a sign of a complication.

The yellow discharge you are experiencing could be a result of several factors:
1. Normal Healing Process: After surgery, the body goes through a healing process that can involve the secretion of fluids. This can sometimes appear yellowish, especially if there is some blood mixed in.

2. Infection: If the discharge has an unpleasant odor, is accompanied by increased pain, fever, or swelling, it could indicate an infection at the surgical site. Infections can occur post-operatively, and they may require antibiotic treatment.

3. Wound Healing Issues: If you feel a lump or a wound at the anal area, it could be a sign of a complication such as a hematoma (a localized collection of blood outside of blood vessels), or it could be related to the surgical site not healing properly.

Given that you are experiencing ongoing symptoms more than a month after surgery, it is advisable to follow up with your surgeon or a healthcare provider. They may want to examine the area to ensure that there are no signs of infection or other complications.
In terms of care at home, continue to keep the area clean and dry. Warm sitz baths can help alleviate discomfort and promote healing. Avoid straining during bowel movements, and consider a high-fiber diet or stool softeners to prevent constipation, which can put additional strain on the surgical site.

As for your concerns about the ongoing discharge and the presence of a wound, it is not typical for a surgical site to remain open or to have persistent discharge for an extended period. Therefore, a thorough examination by a healthcare professional is warranted to rule out any complications and to provide appropriate treatment if necessary.

In summary, while some discharge can be normal after hemorrhoid surgery, persistent yellow discharge and the sensation of a wound should be evaluated by a healthcare provider. They can provide the necessary interventions to ensure proper healing and address any complications that may arise. Your comfort and health are paramount, so do not hesitate to seek medical advice.

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