Post-Surgery Symptoms: What to Expect After Fistula and Hemorrhoid Surgery

After hemorrhoid surgery, what is the string-like substance in the anal canal?

Hello, Dr.
Ke.
Last weekend, I underwent fistula and hemorrhoid surgery at China Medical University.
The nurse informed me that I need to insert my finger about one finger's breadth into the anus to apply the medication in a rotating motion.
I have a small 2 cm opening at the back of the anal area from the fistula wound, and every time I insert my finger to apply the medication, I can clearly feel a thin, elongated structure.
This structure connects outward to the opening of the fistula, and I am very concerned whether this indicates a recurrence or if it was not completely excised.
Can a fistula appear inside the anus, or is that just a manifestation of the postoperative wound? Five days post-surgery, I consulted with the doctor, who told me it was just a trace of the wound.
However, I have been feeling strange while applying the medication these past few days; why does this elongated structure continue to exist? I would appreciate your clarification.
Thank you.

Zhan, 20~29 year old female. Ask Date: 2021/09/03

Dr. Ke Fangxu reply Surgery

A fistula can indeed occur within the anus, so during surgery, the incision may extend into the anal canal.
As for the so-called tubular structure you felt, I cannot determine what it is.
If the surgeon indicates that it is scar tissue from the wound, then there should be no issue.
If you still have concerns, you might consider consulting another doctor for a second opinion.

Reply Date: 2021/09/03

More Info

After undergoing surgery for a fistula and hemorrhoids, it's common to experience a range of symptoms as your body heals. The presence of a small opening at the surgical site, as you described, is not unusual. However, your concerns about the long, thin structure you can feel during your post-operative care are valid and deserve careful consideration.

Firstly, it's important to understand that after surgery for a fistula, the healing process can lead to various sensations and appearances at the surgical site. The "long, thin structure" you are feeling could be a part of the healing tissue or scar tissue that forms as the body repairs itself. In some cases, the remnants of the fistula may still be palpable, especially if the surgery involved a complex fistula that was not entirely excised. However, if your surgeon has assured you that what you are feeling is merely a part of the healing process, it is likely that this is the case.

Fistulas can indeed have internal components that may not be fully visible or accessible during surgery. If the fistula was not completely removed or if there are any residual tracts, they may still be present and could potentially lead to recurrence. However, this does not necessarily mean that your surgery was unsuccessful. Healing can take time, and the presence of some tissue may be a normal part of recovery.

In terms of post-operative care, it is crucial to follow your surgeon's instructions closely. The application of medication as directed is essential for preventing infection and promoting healing. If you are experiencing discomfort or unusual sensations during this process, it is advisable to communicate these feelings to your healthcare provider. They may want to examine the site to ensure that there are no complications, such as infection or improper healing.

As for the concern about recurrence, it is essential to monitor your symptoms. If you notice increased pain, swelling, discharge, or any other signs of infection, you should seek medical attention promptly. Regular follow-up appointments with your surgeon are also important to assess the healing process and address any concerns you may have.

In summary, while the sensations you are experiencing may be concerning, they are not uncommon after fistula and hemorrhoid surgery. The presence of a long, thin structure could be part of the healing process or scar tissue. However, if you have any doubts or if your symptoms worsen, do not hesitate to reach out to your healthcare provider for further evaluation. They can provide reassurance and guidance tailored to your specific situation, ensuring that your recovery progresses smoothly.

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