Post-Hemorrhoid Surgery: Addressing Complications and Treatment Options

Post-hemorrhoid surgery

My father is 60 years old and underwent traditional hemorrhoid surgery over 20 years ago.
He was too busy to have the stitches removed after the surgery.
He mentioned having a problem with anal stenosis.
Could this issue be caused by not having the stitches removed post-surgery? Additionally, is there still a need to remove the stitches now, and is there any treatment available for the anal stenosis?

Niming, 40~49 year old female. Ask Date: 2023/05/29

Dr. Chen Ronghong reply Surgery

Hello, if the physician used absorbable sutures, there is actually no need to remove them.
Even with non-absorbable sutures, they generally tend to loosen and fall out gradually as tension increases.
Regardless of the type, if anal stenosis causes symptoms such as frequent anal fissure pain, it is necessary to seek medical attention for a physician to examine the condition.

Reply Date: 2023/05/29

More Info

After undergoing hemorrhoid surgery, complications can arise, particularly if post-operative care is not adequately addressed. In your father's case, the fact that he did not return to have his sutures removed could potentially contribute to the narrowing of the anal canal, a condition known as anal stenosis. This can occur when scar tissue forms excessively around the surgical site, leading to a constricted passage.

Understanding Anal Stenosis
Anal stenosis is characterized by a narrowing of the anal canal, which can lead to various symptoms, including difficulty with bowel movements, pain during defecation, and sometimes even fecal impaction. In your father's situation, the long duration since the surgery and the absence of suture removal may have exacerbated the formation of scar tissue, resulting in the narrowing he is experiencing.

Is Suture Removal Necessary?
Regarding the necessity of suture removal at this point, it is essential to consult with a healthcare professional. If the sutures are still present and causing irritation or contributing to the narrowing, their removal may be beneficial. However, if the sutures have already dissolved or are no longer present, the focus should shift to addressing the symptoms and complications arising from the stenosis itself.

Treatment Options for Anal Stenosis
1. Dietary Modifications: Increasing fiber intake can help soften stools, making bowel movements easier and less painful. This can be achieved through a diet rich in fruits, vegetables, and whole grains, or through fiber supplements.

2. Stool Softeners: Over-the-counter stool softeners can be helpful in preventing constipation, which can exacerbate the symptoms of anal stenosis.

3. Dilation Therapy: If the narrowing is significant, a healthcare provider may recommend anal dilation. This procedure involves gradually stretching the anal canal to alleviate the constriction. It can be performed in a clinical setting or at home with the guidance of a healthcare professional.

4. Surgical Intervention: In cases where conservative measures fail, surgical options may be considered. This could involve a procedure to remove excess scar tissue or to reconstruct the anal canal to restore its normal diameter.

5. Follow-Up Care: Regular follow-up with a gastroenterologist or a colorectal surgeon is crucial. They can monitor the condition and recommend further interventions if necessary.

Conclusion
In summary, your father's anal narrowing could indeed be related to the lack of post-operative care, particularly the failure to remove sutures. It is advisable for him to consult with a healthcare professional who specializes in colorectal issues. They can provide a thorough examination and recommend appropriate treatment options based on the severity of the stenosis. Early intervention can significantly improve quality of life and prevent further complications.

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