Post-Surgery Recovery and Risks for Hemorrhoid Surgery

Post-hemorrhoidectomy

I previously experienced severe bleeding due to hemorrhoids and later consulted a physician who recommended surgery.
Subsequently, I may have developed anal stenosis, and most doctors have responded that I should not have undergone surgery in the first place.
I do regret this decision, but I respect the professional judgment made at that time, so I won't elaborate further on that.

I mainly want to inquire about the following:
1.
The doctors have mostly told me that a second surgery would require 3 to 6 months for the wound to heal before proceeding with a flap surgery.
Could you please explain how the healing process typically progresses over the 3 to 6 months? Is it possible for the wound to narrow due to scabbing (around one month post-surgery), and then gradually improve (around three months post-surgery)? I understand it won't return to its original state, but I would like to have a general understanding of the healing timeline.
2.
If I undergo flap surgery, what are the advantages and disadvantages? When I previously asked the doctor about potential complications from hemorrhoid surgery, he stated there were none, and he has given me the same response this time.
Therefore, I would like to hear opinions from other experts.
3.
A doctor advised me to manually assist with bowel movements if I was unable to do so.
I have indeed done this, but I would like to know if there is a possibility that the cleanliness of my fingers (despite washing my hands) could exacerbate the scabbing of the wound.

LYL, 20~29 year old female. Ask Date: 2021/03/27

Dr. Ke Fangxu reply Surgery

1.
After hemorrhoid surgery, if anal stenosis occurs, it is recommended to wait for six months until the scar tissue stabilizes before considering flap surgery.
During this period, the use of stool softeners along with regular anal dilation may help improve the stenosis.
If there is improvement, flap surgery may not be necessary.
2.
Flap surgery can result in significant scarring, and sometimes the improvement in stenosis may not be noticeable.
Additionally, there are risks of wound infection or poor healing.
3.
You can purchase latex gloves or disposable plastic gloves for use.

Reply Date: 2021/03/27

More Info

When it comes to post-surgery recovery and risks associated with hemorrhoid surgery, it's essential to understand the healing process, potential complications, and the implications of further surgical interventions.
1. Healing Process After Hemorrhoid Surgery: After hemorrhoid surgery, the recovery timeline can vary significantly from patient to patient. Generally, the initial healing phase can take about 3 to 6 weeks, during which the surgical site will undergo various stages of healing. In the first week, you may experience pain, swelling, and some bleeding, which are common after such procedures. By the end of the first month, the wound should start to form a scab, and while it may feel tight or narrow, this is a normal part of the healing process.
It’s possible for the wound to initially feel constricted due to scabbing, but as healing progresses, the tissue may soften and expand. By the three-month mark, many patients notice significant improvement, although complete healing can take longer. It's important to follow your doctor's advice regarding wound care and to monitor for any signs of infection or complications, such as increased pain, redness, or discharge.

2. Pros and Cons of Flap Surgery: If a secondary procedure, such as flap surgery, is recommended, it’s crucial to weigh the benefits and risks. Flap surgery can be beneficial for correcting issues like anal stenosis (narrowing of the anal canal) that may arise after the initial hemorrhoid surgery. The advantages include potentially restoring normal function and alleviating symptoms associated with narrowing. However, flap surgery also carries risks, including infection, delayed healing, and the possibility of requiring further surgeries if complications arise.
It's worth noting that while some surgeons may downplay the risks of the initial hemorrhoid surgery, complications can occur, and it's essential to have a thorough discussion with your healthcare provider about your specific case and any potential long-term effects.

3. Self-Care and Hygiene Concerns: Regarding the advice to manually assist with bowel movements, while it can be a temporary solution for constipation, it’s crucial to approach this carefully. Even with proper hand hygiene, there is a risk of introducing bacteria to the surgical site, which could lead to infection or worsen scabbing. Instead, consider discussing dietary changes, hydration, and possibly the use of stool softeners with your doctor to promote regular bowel movements without the need for manual intervention.

In conclusion, recovery from hemorrhoid surgery can be complex, and while many patients do well, some may experience complications that require additional procedures. It's essential to maintain open communication with your healthcare provider, adhere to post-operative care instructions, and seek medical advice if you notice any concerning symptoms during your recovery. Regular follow-ups will help ensure that any issues are addressed promptly, and your recovery is as smooth as possible.

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