Failed Hemorrhoid Ligation: What to Do Next?

Failed hemorrhoid ligation?

I had a hemorrhoid ligation at the postal hospital a week ago, but on the third day, I experienced bleeding due to a large bowel movement.
Even now, a week later, my hemorrhoids still protrude during bowel movements.
I tried to check with my hand while wearing a condom and using lubricant, but I couldn't feel the rubber band; does this mean the procedure has failed (this is the third ligation)? Additionally, it seems that my prostate has become significantly enlarged; I can feel it without having to insert my finger deeply, which normally should require bending my finger to feel it.
Could the ligation have caused prostatitis? I had chronic prostatitis four years ago, and now I am experiencing severe urinary frequency.
Given this situation, should I first consult a urologist or seek another hemorrhoid ligation? Thank you, doctor.

Wang, 20~29 year old female. Ask Date: 2018/04/24

Dr. Ke Fangxu reply Surgery

The rubber band ligation for hemorrhoids is primarily a treatment for bleeding internal hemorrhoids.
It may not be effective for larger hemorrhoids that prolapse outside the anus.
The rubber band typically falls off about a week after the procedure, and early detachment is also a common occurrence that does not require special intervention.
As for whether what you felt is the prostate, it is advisable to have a physician examine it for accuracy.
I recommend that you first consult a urologist.
If there are no specific discomforts, there is no need to undergo rubber band ligation for hemorrhoids.

Reply Date: 2018/04/24

More Info

It sounds like you are experiencing a challenging situation following your hemorrhoid ligation procedure. Let's break down your concerns and provide some guidance on what steps to take next.

Firstly, regarding the failed hemorrhoid ligation, it is not uncommon for ligation procedures to have varying degrees of success. If you are still experiencing protrusion of the hemorrhoids and bleeding after a week, it may indicate that the ligation was not successful, especially if you cannot feel the rubber band that was supposed to cut off the blood supply to the hemorrhoid. In such cases, it is advisable to consult with your healthcare provider or a colorectal specialist to evaluate the situation. They may recommend a follow-up examination, which could include a physical examination or possibly an imaging study to assess the condition of the hemorrhoids and determine the best course of action.

As for your concerns about prostate enlargement, it is important to note that while hemorrhoid ligation itself is not directly linked to prostate inflammation, the stress and straining associated with bowel movements can exacerbate existing prostate issues. Given your history of chronic prostatitis, it is possible that the increased frequency of urination and the sensation of an enlarged prostate could be related to your overall health and lifestyle factors, including diet, hydration, and physical activity.

You mentioned that you are experiencing frequent urination, which can be a symptom of prostate enlargement or inflammation. It would be prudent to consult a urologist to address these symptoms. They can perform a thorough evaluation, which may include a digital rectal exam (DRE) to assess the size of the prostate, as well as other diagnostic tests such as a prostate-specific antigen (PSA) test or imaging studies if necessary.

In summary, here are the steps you should consider taking:
1. Consult a Colorectal Specialist: Schedule an appointment to discuss the outcomes of your hemorrhoid ligation. They can assess whether the procedure was successful and discuss potential next steps, which may include re-ligation or other treatment options.

2. Visit a Urologist: Given your symptoms of frequent urination and concerns about prostate enlargement, it would be beneficial to see a urologist. They can help determine if your symptoms are related to prostate issues and recommend appropriate treatment.

3. Monitor Symptoms: Keep track of your symptoms, including any changes in bowel habits, urinary frequency, or discomfort. This information will be valuable for your healthcare providers in making an accurate diagnosis.

4. Lifestyle Modifications: Consider making lifestyle changes that may help alleviate some of your symptoms. This could include increasing fiber intake to ease bowel movements, staying well-hydrated, and avoiding straining during bowel movements.

5. Follow-Up Care: Ensure that you have a plan for follow-up care with both specialists. Regular monitoring and communication with your healthcare providers are key to managing your conditions effectively.

In conclusion, while it can be concerning to experience complications after a procedure, there are steps you can take to address your symptoms and improve your health. Seeking professional medical advice is crucial in navigating these issues effectively.

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