Post-Operative Concerns After Laser Hemorrhoid Surgery: What to Expect

Postoperative Issues After Hemorrhoid Laser Surgery

Hello Dr.
Ke: I had laser surgery for hemorrhoids at the clinic on the evening of April 23 (Friday) and was not hospitalized.
One external hemorrhoid and one mixed hemorrhoid were removed.
As of now, April 25 (Sunday), it is the second night since the surgery, and I have a few questions to ask you:
1.
The wound is still severely painful, and there is not much bleeding.
The area of my underwear appears damp; is this tissue fluid?
2.
I have been using a stool softener, and the bowel movements are quick, but during and after the bowel movements, there is excruciating pain in the entire anal area.
It feels like the previously healing wound has been injured again, and the area around the anus feels swollen.
Is this normal? Will the wound split open?
3.
There is a burning sensation at the wound site.
Could this be cellulitis, or is it a normal part of the healing process? What symptoms would necessitate a prompt visit to the hospital? I am very worried about losing function in my anus.

4.
How long can I expect the severe pain to last before it subsides?

A Meng, 30~39 year old female. Ask Date: 2021/04/25

Dr. Ke Fangxu reply Surgery

1.
It may be difficult to make a judgment without a personal examination.

2.
Generally, standard hemorrhoid surgeries require hospitalization to manage postoperative pain and swelling, which are common phenomena.
Whether the wound will reopen depends on the surgical method used.
The term "hemorrhoid laser surgery" is vague and does not specify the instruments or techniques employed, making it impossible to assess.

3.
Whether it is cellulitis cannot be diagnosed through online consultation.
If you are feeling very uncomfortable, it is advisable to seek examination and treatment from a colorectal surgeon as soon as possible.

4.
Traditional hemorrhoidectomy is usually most painful during the first three days, after which the pain significantly decreases, and it typically takes about 1-2 weeks to become completely pain-free.
As for how long your "hemorrhoid laser surgery" will be painful, it cannot be determined without knowing the specific surgical method used.

Reply Date: 2021/04/25

More Info

After undergoing laser hemorrhoid surgery, it is common to have concerns regarding post-operative symptoms and recovery. Here’s a comprehensive overview of what to expect and how to manage your symptoms effectively.

1. Pain Management: It is normal to experience significant pain following hemorrhoid surgery, especially within the first few days post-operation. The pain can be intense, particularly during bowel movements. This discomfort is often due to the surgical trauma to the sensitive tissues in the anal region. It is crucial to manage this pain effectively. Over-the-counter pain relievers such as acetaminophen or ibuprofen can be helpful, but always consult your physician before taking any medication. If the pain is unmanageable, your doctor may prescribe stronger pain relief.

2. Discharge and Fluid Accumulation: The moistness you observe in your underwear could indeed be tissue fluid, which is common after surgery. This fluid is part of the healing process. However, if you notice a significant increase in discharge or if it has a foul odor, it could indicate an infection, and you should contact your healthcare provider.

3. Bowel Movements and Pain: It is good that you are using a stool softener, as straining during bowel movements can exacerbate pain and potentially lead to complications such as wound reopening. The pain during and after bowel movements is not unusual, but it should gradually improve as the surgical site heals. If you feel that the pain is worsening or if you notice any bleeding during bowel movements, it is essential to seek medical advice.

4. Swelling and Burning Sensation: Swelling around the surgical site can occur as part of the healing process. However, if you experience a burning sensation, it could be a sign of infection, such as cellulitis or abscess formation. While some discomfort is expected, severe symptoms like increased redness, warmth, or pus should prompt immediate medical evaluation.

5. Signs of Complications: You should seek medical attention if you experience any of the following:
- Severe or worsening pain that does not respond to medication.

- Significant swelling or redness around the surgical site.

- Fever or chills, which could indicate an infection.

- Any signs of excessive bleeding or discharge that is foul-smelling.

6. Recovery Timeline: The intensity of pain typically decreases over the first week, but complete healing can take several weeks. Most patients find that their pain significantly improves within 7 to 10 days, but this can vary based on individual circumstances and the extent of the surgery.
7. Post-Operative Care: To facilitate healing, it is advisable to:
- Maintain a high-fiber diet to prevent constipation.

- Stay well-hydrated.

- Avoid straining during bowel movements.

- Use warm sitz baths to soothe the area and promote blood flow.

- Follow any specific instructions provided by your surgeon regarding wound care and activity restrictions.

In summary, while post-operative pain and discomfort are expected after laser hemorrhoid surgery, it is essential to monitor your symptoms closely. If you have any concerns about your recovery or if your symptoms worsen, do not hesitate to reach out to your healthcare provider for further evaluation and guidance. Your health and comfort are paramount, and timely intervention can prevent complications and promote a smoother recovery.

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