Post-Surgery Concerns: Perineal Swelling After Hemorrhoid Surgery

Post-hemorrhoidectomy perineal swelling?

I underwent traditional surgery for mixed hemorrhoids on November 24th last year, and it has been approximately 2.5 months since then.
I would like to ask the following questions:
1.
After the surgery, I experienced swelling in the perineal area (the area between the anus and the vaginal opening).
My primary physician informed me that this was normal and later prescribed a topical medication, which I applied for about 2-3 weeks.
Although there has been some reduction in swelling, it has not completely resolved.
When I touch the area, it feels like a long, hard mass that is slightly painful, and I often experience mild pain, especially when sitting down.
I would like to know why surgery for hemorrhoids can cause swelling in the perineal area.
Is this normal? Is the mass composed of a blood clot or scar tissue? How long might it take to resolve? I am really concerned that there might be an issue since it hasn’t gone away and I frequently feel mild pain.
2.
About 1.5 months after the surgery, a skin tag suddenly appeared on the right side of the anal area.
I have been applying the topical medication for 2-3 weeks, but it has not diminished.
Although it is not uncomfortable most of the time, I do notice a sensation of foreign body and swelling after having a bowel movement.
How long might it take for this skin tag to resolve? Will it potentially develop into a new hemorrhoid in the future?

Xiao Li, 40~49 year old female. Ask Date: 2021/02/13

Dr. Ke Fangxu reply Surgery

1.
It is necessary to conduct a physical examination to determine the exact issue.
Generally, swelling after surgery improves within 2 to 4 weeks.
If it persists for three months post-surgery, it is advisable to have the surgeon conduct a follow-up evaluation.

2.
Similarly, an examination is required to assess whether there may be excess skin resulting from the healing of the surgical wound.
If there is no pain or bleeding, it can be ignored; otherwise, you may consult a physician to see if surgical removal is necessary.

Reply Date: 2021/02/13

More Info

After undergoing hemorrhoid surgery, particularly a mixed hemorrhoid procedure, it is not uncommon to experience perineal swelling and discomfort. Your concerns about the swelling and the hard, painful area you described are valid and warrant a thorough understanding of the post-operative healing process.

1. Understanding Perineal Swelling: The perineal area, which lies between the anus and the vagina, can swell post-surgery due to several factors. Surgical trauma, inflammation, and the body's natural healing response can lead to swelling in this region. The presence of a hard, elongated area that is slightly painful could indicate a few possibilities: it may be a hematoma (a localized collection of blood outside of blood vessels), scar tissue, or simply residual swelling from the surgical procedure. It is essential to monitor the characteristics of this swelling. If it appears to be increasing in size, becomes more painful, or shows signs of infection (such as redness, warmth, or discharge), you should contact your healthcare provider promptly.

2. Duration of Swelling: Generally, post-operative swelling can take several weeks to months to resolve completely. The timeline can vary significantly based on individual healing rates, the extent of the surgery, and adherence to post-operative care instructions. While some patients may notice improvement within a few weeks, others may experience lingering swelling for several months. It is crucial to maintain follow-up appointments with your surgeon to assess the healing process and address any concerns.

3. New Growth Near the Anus: The appearance of a new skin growth near the anus after surgery can be concerning. It is essential to differentiate between a benign skin tag, a recurrence of hemorrhoids, or another type of growth. Skin tags can develop after surgery as a result of skin stretching or irritation. If the growth persists or causes discomfort, it is advisable to have it evaluated by your surgeon or a specialist. They can determine the nature of the growth and recommend appropriate treatment if necessary.

4. Potential for New Hemorrhoids: The risk of developing new hemorrhoids after surgery can depend on various factors, including lifestyle, bowel habits, and genetic predisposition. Maintaining a high-fiber diet, staying hydrated, and avoiding straining during bowel movements can help reduce the risk of recurrence. If you notice symptoms similar to those experienced before surgery, such as pain, bleeding, or a feeling of fullness, it is essential to seek medical advice.

5. Post-operative Care: Continue to follow your surgeon's post-operative care instructions, including the use of prescribed medications like the topical ointment you mentioned. Warm sitz baths can also provide relief and promote healing. If you have not already, consider discussing your symptoms with your healthcare provider, as they may recommend additional treatments or interventions to alleviate discomfort and promote healing.

In summary, while some degree of swelling and discomfort is expected after hemorrhoid surgery, persistent symptoms warrant further evaluation. Regular follow-ups with your healthcare provider are crucial to ensure proper healing and to address any complications that may arise. Your concerns are valid, and seeking clarification and reassurance from your medical team is an essential part of your recovery process.

Similar Q&A

Post-Surgery Swelling Concerns After Minimally Invasive Hemorrhoid Surgery

Dear Dr. Chang, I underwent a Legasure procedure 18 days ago to excise two external hemorrhoids and one mixed hemorrhoid (and possibly one or two internal hemorrhoids). Post-surgery, I have been taking sitz baths twice daily and rinsing with warm water or using wet wipes after e...

Dr. Zhang Shuhao reply Surgery
In general, after a complete excision of internal and external hemorrhoids, there will be significant swelling at the surgical site. The degree and duration of the swelling are related to the severity of the original hemorrhoids, and it is common for patients to experience swelli...

Post-Hemorrhoid Surgery: Common Concerns and Pain Management

Hello, doctor. It has been four days since my external hemorrhoidectomy, and I am still experiencing unbearable pain. The area around the wound is swollen around half of the anus. I have been lying in bed and relying on painkillers to manage my daily activities. However, I read t...

Dr. Ke Fangxu reply Surgery
Personally, I have not undergone outpatient hemorrhoidectomy because postoperative swelling and pain are inevitable. Mild bleeding and discharge are also considered normal. During this time, it is not recommended to apply ointments to avoid compromising wound cleanliness. Frequen...

Post-Surgery Concerns: Managing Persistent Symptoms After Hemorrhoid Surgery

Hello Dr. Ke, I underwent a hemorrhoidectomy in mid-April, and now it has been three and a half months. I've observed that the tissue outside my anus doesn't seem to have reduced in size, and there is still a ring around it. I thought that after waiting this long, it wo...

Dr. Ke Fangxu reply Surgery
Hello Ada: After hemorrhoid surgery, swelling typically subsides within a month, and you should return to a normal state, although there may be some residual skin tags. However, if there is still a ring of swelling, it may indicate an abnormal condition. In rare cases, if diarrhe...

Understanding Post-Surgery Complications: Hemorrhoid Surgery Recovery Issues

Hello Dr. Ke, my surgical wound from April 17 hasn't healed and has been bleeding. There are two protrusions near the perineum, and I have persistent pain in my left buttock. I've returned for follow-ups over ten times, and the doctor advised me to apply medication and ...

Dr. Huang Zhihui reply Surgery
Traditional hemorrhoid surgery involves the removal of the primary hemorrhoidal tissue, and common postoperative complications include pain, bleeding, and residual tags or small hemorrhoids. Based on your description, it seems you may be experiencing such issues. If you are still...