Complications After Hemorrhoid Ligation: Pain and Urinary Issues - Surgery

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It sounds like you're experiencing a complex set of symptoms following your hemorrhoid ligation, including pain, urinary difficulties, and gastrointestinal issues. Let's break down your concerns and explore possible explanations and recommendations.

Firstly, the sudden pain in your right flank during the hemorrhoid ligation could be related to several factors. This pain might not be directly linked to the procedure itself but could be indicative of referred pain from nearby structures, such as the kidneys or the ureters. Given your urinary symptoms, it’s possible that there may be an underlying issue with your urinary tract, such as a kidney stone or an obstruction that could be causing both the pain and the urinary difficulties.

Your description of urinary issues, including slow urine flow and the sensation of needing to push to urinate, raises concerns about potential bladder dysfunction or obstruction. While you mentioned that you are taking medication for benign prostatic hyperplasia (BPH) and overactive bladder, it's important to note that at your age, BPH is unlikely. However, other conditions such as bladder stones, urethral strictures, or even neurological issues affecting bladder control could be contributing to your symptoms.

The fact that you also experience discomfort in your lower abdomen and have to adopt certain positions to relieve gas suggests that there may be some gastrointestinal involvement as well. Constipation or fecal impaction can lead to abdominal discomfort and may even affect urinary function due to the close proximity of the rectum and bladder. If you are experiencing difficulty with bowel movements despite a diet rich in vegetables and hydration, it may be worth exploring other dietary factors or potential gastrointestinal issues.

Given that you've undergone multiple urological evaluations without definitive answers, it may be beneficial to consider a multidisciplinary approach. Here are some recommendations:
1. Follow-Up with a Urologist: Since you are experiencing persistent urinary symptoms, a follow-up appointment with a urologist is crucial. They may consider imaging studies, such as an ultrasound or CT scan, to evaluate for kidney stones or other structural abnormalities.

2. Gastroenterology Consultation: Given your gastrointestinal symptoms, a consultation with a gastroenterologist may help identify any underlying issues related to bowel function. They can assess for conditions such as irritable bowel syndrome (IBS) or other functional gastrointestinal disorders.

3. Pelvic Floor Physical Therapy: If there is a possibility of pelvic floor dysfunction contributing to your urinary and bowel symptoms, pelvic floor physical therapy could be beneficial. This therapy focuses on strengthening and relaxing the pelvic floor muscles, which can improve both urinary and bowel function.

4. Dietary Review: While you are consuming vegetables and staying hydrated, it may be helpful to keep a food diary to identify any potential triggers for your symptoms. Additionally, consider consulting with a nutritionist who specializes in gastrointestinal health.

5. Stress Management: Chronic stress can exacerbate both urinary and gastrointestinal symptoms. Incorporating stress management techniques such as mindfulness, yoga, or counseling may provide some relief.

6. Regular Monitoring: Since you mentioned feeling increasingly unwell, regular follow-ups with your healthcare providers are essential to monitor your symptoms and adjust treatment as necessary.

In conclusion, your symptoms are multifaceted and may require a comprehensive evaluation to identify the underlying causes. It’s important to advocate for yourself and seek further evaluations until you receive the answers and relief you need. Remember, you are not alone in this, and there are healthcare professionals who can help you navigate these challenges.