Post-Hemorrhoid Surgery Complications: Discomfort and Erectile Issues Explained

Postoperative Issues After Hemorrhoid Surgery

Hello Dr.
Ke: I underwent a mixed hemorrhoid ultrasound knife circumcision surgery in Kaohsiung in October 2018.
There is still excess tissue swelling that has not subsided, and I continue to feel a dull discomfort in the anal area every day, especially after sitting for a long time (about half an hour to an hour), walking all day, or not having a bowel movement for a day.
This discomfort tends to ease in the morning after waking up, after lying down for a long time, after being inverted, after warm sitz baths, or after having a bowel movement.
What could be the issue? What should I do? Additionally, since the hemorrhoid surgery, my erectile function has significantly declined compared to before.
I now find it difficult to achieve morning erections and natural erections, and the hardness and duration of erections are much worse than they used to be.
What could be the problem? What should I do? This is very distressing...
I would appreciate your help in clarifying these issues.
Thank you.

Billy, 30~39 year old female. Ask Date: 2019/12/21

Dr. Ke Fangxu reply Surgery

According to my knowledge, the ultrasonic scalpel and the circumcision surgery are different surgical methods that utilize different instruments.
The ultrasonic scalpel often has issues with slower healing, while swelling of external hemorrhoids is a common problem associated with circumcision surgery.
Discomfort in the anal area may occur in patients where the circumcision is performed too low.
It is generally recommended to take warm sitz baths to alleviate discomfort.
In general, these types of surgeries do not affect sexual function; however, if the depth of the circumcision is too deep, there may be short-term effects.
It is advisable to consult with the surgeon for better guidance, and if necessary, you can also seek further examination and treatment from a urologist.

Reply Date: 2019/12/21

More Info

Post-hemorrhoid surgery complications can be quite distressing, and it’s understandable that you are experiencing discomfort and erectile issues following your procedure. Let's break down your concerns and explore the potential causes and solutions.

Discomfort After Hemorrhoid Surgery
The discomfort you are experiencing in the anal area, particularly after prolonged sitting or walking, is not uncommon after hemorrhoid surgery. The surgery, especially if it involved the removal of tissue, can lead to residual swelling or irritation in the area. Here are some potential reasons for your ongoing discomfort:
1. Residual Swelling: After surgery, it is normal for some swelling to persist. This can lead to a sensation of fullness or discomfort, especially after sitting for long periods.

2. Scar Tissue Formation: The healing process can lead to the formation of scar tissue, which may cause tightness or discomfort in the anal area. This can be exacerbated by prolonged sitting or straining during bowel movements.

3. Anal Spasms: Post-surgical anal spasms can occur, leading to discomfort. These spasms may be triggered by stress, prolonged sitting, or bowel movements.

4. Infection or Complications: Although less common, infections or complications from the surgery can lead to persistent discomfort. Signs of infection include increased pain, swelling, redness, or discharge.

5. Bowel Habits: If you are experiencing constipation or straining during bowel movements, this can exacerbate discomfort. Maintaining regular bowel habits and avoiding straining is crucial.

Recommendations for Managing Discomfort
- Warm Sitz Baths: Taking warm sitz baths can help soothe the area and reduce discomfort. This can be particularly beneficial after bowel movements.

- Dietary Adjustments: Ensure you are consuming a high-fiber diet to promote regular bowel movements and prevent straining. Staying hydrated is also essential.

- Pain Management: Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help manage discomfort. However, consult your doctor before taking any medication.

- Follow-Up with Your Surgeon: If discomfort persists or worsens, it’s essential to follow up with your surgeon. They can assess for any complications or recommend further treatment options.

Erectile Dysfunction Post-Surgery
Regarding your erectile dysfunction (ED) following the hemorrhoid surgery, this is a more complex issue. While hemorrhoid surgery is not directly related to erectile function, there are several factors that could contribute to your experience:
1. Nerve Damage: Although rare, surgical procedures in the pelvic area can potentially affect the nerves responsible for erectile function. If there was any manipulation or trauma to the surrounding tissues, it could lead to temporary or, in some cases, longer-lasting issues.

2. Psychological Factors: Surgery and the associated discomfort can lead to anxiety or stress, which can impact sexual performance. The psychological aspect of recovery should not be underestimated.

3. Blood Flow Issues: If you are experiencing discomfort in the pelvic area, this could potentially affect blood flow, which is crucial for achieving and maintaining an erection.

4. Hormonal Changes: Stress and discomfort can lead to hormonal changes that may affect libido and erectile function.

Recommendations for Erectile Dysfunction
- Consult a Urologist: It’s advisable to consult a urologist who specializes in erectile dysfunction. They can perform a thorough evaluation and recommend appropriate treatments.

- Counseling: If psychological factors are contributing to your ED, talking to a therapist or counselor may help address these concerns.

- Lifestyle Modifications: Regular exercise, a healthy diet, and avoiding smoking or excessive alcohol can improve overall health and potentially enhance erectile function.

- Medications: There are various medications available that can help with erectile dysfunction. A healthcare provider can discuss these options with you.

Conclusion
It’s essential to address both your discomfort and erectile issues with your healthcare providers. Persistent symptoms warrant further investigation to rule out complications and to explore effective treatment options. Remember, recovery can take time, and open communication with your medical team is key to ensuring a smooth healing process.

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