Post-Laser Hemorrhoid Surgery: Common Concerns and Recovery Issues

Postoperative Issues After Laser Hemorrhoid Surgery

Hello Dr.
Ke, I hope you can answer my questions.
I'm very concerned about various issues during my recovery period.
I underwent laser hemorrhoid surgery on July 16, where a line was inserted into the hemorrhoid to cauterize the vein (approximately like this).

1) One week after the hemorrhoid surgery, I experienced a sudden and significant rectal bleeding, with a large amount of blood clots and fresh blood pouring out.
I was taken to the hospital, and the surgeon later examined me and found a bleeding point in the internal hemorrhoid at the 6 o'clock position.
They performed another surgery to ligate that bleeding point.
Do you know why there was such significant bleeding after the surgery?
2) About two weeks post-surgery, the wound at the anal area began to heal, but suddenly a small, slightly flat, pinkish bump appeared at a spot where there was no prior wound.
It is very itchy and feels sharp when touched.
I have been taking sitz baths at least twice a day.
Is this swelling? How long might it take to resolve?
3) Since the surgery, the shape of my stools has been flat.
How long do you think it will take for them to return to their normal shape?
Thank you very much for your response, and I wish you good health!

Miss Wang, 20~29 year old female. Ask Date: 2020/07/30

Dr. Ke Fangxu reply Surgery

The term "laser" refers to specific types of lasers.
Currently, the lasers commonly used in medical applications for tissue cutting are the thulium laser and the green light laser; however, these are quite expensive and are rarely used in hemorrhoid surgeries.
Some practitioners also refer to infrared coagulation devices, harmonic scalpels, and circular excision as laser surgeries.
It is advisable to clarify which specific surgical method is being used.

1.
As mentioned earlier, if the specific surgical method is not clear, it is difficult to provide a precise answer to this question.
However, it is often the case that the hemorrhoidal blood vessels were not completely ligated or coagulated, which can lead to significant bleeding one week post-surgery.
Addressing the bleeding point directly should resolve the issue.

2.
It is possible that swelling at the surgical site is contributing to the problem; performing warm sitz baths may provide relief.

3.
Changes in stool shape are generally caused by swelling at the surgical site, which exerts pressure.
Typically, normal stool shape can be expected to return within 2 to 4 weeks.

Reply Date: 2020/07/30

More Info

Post-laser hemorrhoid surgery recovery can indeed be a challenging process, and it's understandable that you have concerns regarding your symptoms and recovery. Let's address your questions one by one, while also providing some additional context about the recovery process after such a procedure.

1. Postoperative Bleeding: Experiencing significant bleeding after hemorrhoid surgery, especially within the first week, can be alarming. The bleeding you encountered, particularly from a specific point like the 6 o'clock position of an internal hemorrhoid, may occur due to several reasons. After surgical procedures, the tissue is healing, and blood vessels can become fragile. If a blood vessel was not adequately cauterized or if there was excessive tension on the tissue, it could lead to bleeding. Additionally, straining during bowel movements or even minor trauma to the area can exacerbate bleeding. It's crucial to follow your surgeon's postoperative care instructions, including dietary recommendations to avoid constipation, which can lead to straining.

2. Development of a New Growth: The appearance of a small, flat, pinkish bump at the anal area after surgery could be a few different things. It might be a normal part of the healing process, such as granulation tissue, which is a sign of healing. However, it could also be a sign of a skin tag or a small cyst. The itchiness and pain you are experiencing could be due to irritation or inflammation in the area. While sitz baths are beneficial for promoting healing and comfort, if the bump persists or worsens, it would be advisable to consult your surgeon or a gastroenterologist for a thorough evaluation. Healing times can vary, but many patients find that such bumps resolve within a few weeks to a couple of months.

3. Changes in Bowel Movements: It's not uncommon for patients to experience changes in bowel habits and stool shape after hemorrhoid surgery. The stool may appear flatter or narrower due to swelling or changes in the anal canal's structure as it heals. This can also be influenced by dietary changes or medications taken post-surgery. Typically, as the healing progresses and any inflammation subsides, bowel habits should return to normal. This process can take several weeks to a few months, depending on individual healing rates and adherence to dietary recommendations. Ensuring adequate fiber intake and hydration can help facilitate normal bowel movements.

In summary, recovery from laser hemorrhoid surgery can involve various symptoms, including bleeding, changes in the appearance of the anal area, and alterations in bowel movements. It's essential to maintain open communication with your healthcare provider throughout your recovery. If you experience any severe symptoms, such as excessive bleeding, severe pain, or signs of infection (like fever or increased swelling), seek medical attention promptly.
Lastly, while it’s normal to have concerns during recovery, most patients find that their symptoms improve significantly over time with proper care and attention to their body’s healing process. Wishing you a smooth recovery and improved health!

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