Post-Surgery Concerns: Managing Anal Fistula and Hemorrhoid Recovery

Postoperative care for anal fistula surgery?

Hello, I underwent surgery for anal fistula and hemorrhoids on June 30th.
Initially, in mid-June, I had a noticeable swelling, but it subsided on its own after a couple of days (it can still be felt, but it has shrunk significantly and is not painful).
Before the hemorrhoid surgery at the end of the month, the doctor advised that the fistula should still be addressed to prevent recurrence, so I went ahead with the surgery.
Currently, my post-operative condition is as follows: [link to images].

This morning, when I woke up and changed the dressing, I noticed a swollen area on the wound and I'm unsure if it's a blister or something else.
Previously, I felt that same area was a bit harder, but it hadn't swollen until today.
I change the dressing at least three times a day, and the wound appears slightly smaller than right after the surgery.
During my weekly follow-ups on Wednesdays, the doctor mentioned that the wound was healing gradually and did not indicate any issues, advising me to return in two weeks.
However, today I suddenly noticed this swelling.

Could you please advise what this might be? Should I return to the clinic to see the doctor earlier, or should I leave it alone and see if it resolves on its own? Is there a possibility that I might need another surgery to remove it? Could prolonged sitting cause this condition, or could there be other reasons? Is this considered a normal phenomenon?
Additionally, I have hair growing from my anus to my genital area.
Previously, I would occasionally use a razor to remove some of it, but I haven't dared to do so since the surgery.
The doctor likely trimmed some during the procedure, but it has grown back.
I would like to ask:
1.
Is it common for many people to have hair around the anal area? Is this normal?
2.
If I use a razor, will the hair grow back thicker?
3.
Are there hair removal procedures available for this area, or do you have other recommended methods for managing it? Thank you.

a, 30~39 year old female. Ask Date: 2018/07/22

Dr. Ke Fangxu reply Surgery

Based on the photo you provided, it appears to be an unhealed wound from an anal fistula surgery.
Since this type of wound cannot be sutured, it typically takes about a month to heal.
Regular warm sitz baths and follow-up appointments are recommended.
Additionally, hair growth around the anal area varies from person to person and is generally considered normal.
However, it is not advisable to shave with a razor, as this can easily cause skin damage and lead to infection.
For hair removal procedures, it may be best to consult a dermatologist for more professional advice.

Reply Date: 2018/07/22

More Info

After undergoing surgery for anal fistula and hemorrhoids, it's common to have concerns about recovery and potential complications. Based on your description, it seems that you are experiencing some swelling at the surgical site, which can be a normal part of the healing process. However, it is important to monitor the situation closely.

Post-Surgery Recovery and Concerns
1. Swelling and Hardness: The swelling you noticed could be due to several factors, including fluid accumulation (edema), inflammation, or even a hematoma (a localized collection of blood outside of blood vessels). If the swelling is accompanied by increased pain, redness, or discharge, it may indicate an infection or other complications. Since you mentioned that the swelling appeared suddenly, it would be prudent to consult your surgeon for an evaluation. They may want to assess the area to rule out any issues that could require intervention.

2. Wound Care: Continuing to change the dressing regularly is essential for preventing infection. Ensure that you are following your surgeon's instructions regarding wound care. If the wound appears to be healing but you notice new symptoms, such as increased swelling or discharge, do not hesitate to reach out to your healthcare provider.

3. Sitting and Activity: Prolonged sitting can contribute to discomfort and may exacerbate swelling in the anal region. It is advisable to take breaks and avoid sitting for extended periods. Using a cushion or a specialized donut pillow can help alleviate pressure on the surgical site.

4. Hair Growth Around the Surgical Area: It is normal for hair to grow around the anal area, and many people have hair in this region. If you are concerned about hair removal, it is generally safe to trim hair with scissors rather than shaving, especially while the area is healing. Shaving can lead to irritation or cuts, which may complicate recovery.

5. Hair Removal Options: If you are looking for more permanent hair removal solutions, options such as laser hair removal or electrolysis are available. These methods can reduce hair growth over time but should be discussed with a dermatologist or a licensed professional, especially considering your recent surgery.

Recommendations
- Follow-Up Appointment: Since you have noticed a change in your condition, it would be wise to schedule an earlier follow-up appointment with your surgeon. They can provide a thorough examination and determine whether any further treatment is necessary.

- Monitor Symptoms: Keep track of any changes in your symptoms, such as increased pain, fever, or unusual discharge. If you experience any of these, seek medical attention promptly.

- Rest and Recovery: Ensure you are getting adequate rest and nutrition to support your healing process. Hydration and a high-fiber diet can help prevent constipation, which is crucial after anal surgery.

- Avoid Self-Treatment: While it may be tempting to manage symptoms on your own, avoid self-diagnosing or treating potential complications without professional guidance.

In summary, while some swelling and discomfort can be expected after anal surgery, any sudden changes warrant a discussion with your healthcare provider. They can provide the best guidance tailored to your specific situation and ensure that your recovery proceeds smoothly.

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