Post-Surgery Discomfort After Hemorrhoid Procedures: A Patient's Journey

Postoperative discomfort after hemorrhoid surgery?

Hello Dr.
Ke, I would like to ask about my situation.
Three years ago, I underwent a circular excision hemorrhoid surgery at a certain hospital.
Last year, due to a recurrence, I went to a gynecology clinic for another hemorrhoid surgery.
The first treatment at the hospital had a good recovery, but my irregular lifestyle may have led to the recurrence.
Following a friend's recommendation, I visited the clinic.

After the surgery in May last year, I experienced intense stabbing pain postoperatively, and I often had sharp pain and bleeding during bowel movements for about seven to eight months.
Eventually, I couldn't tolerate this condition anymore and went to a nearby hospital for consultation.
The doctor found it very painful during the digital examination and diagnosed me with anal stenosis.
After deciding to perform surgery, they discovered a needle at the site that was painful during the examination.
After removing the needle, the stabbing pain disappeared.
When I returned to the clinic to explain this situation, they stated that it was not their issue and that the discomfort was caused by the needle from my first hemorrhoid surgery at the hospital.
However, I am puzzled as to how a needle from three years ago could suddenly cause such intense discomfort only after the clinic surgery.
After the clinic procedure, I felt even more pain than before the recurrence for nearly a year.
I would like to know how to resolve this situation.
Thank you.

Kaila, 30~39 year old female. Ask Date: 2024/03/20

Dr. Ke Fangxu reply Surgery

If the tingling sensation has disappeared, what other issues need to be addressed? It is possible that the staples from the first surgery are causing concerns, and it may depend on how the second surgery was performed or what instruments or materials were used.
It is also possible that the second surgery caused the previous staples to become exposed.
However, only the surgeon can provide clarity on this matter.

Reply Date: 2024/03/20

More Info

After undergoing hemorrhoid surgery, it is not uncommon for patients to experience discomfort and complications. Your journey highlights a series of challenges that can arise post-surgery, particularly when dealing with recurrent hemorrhoids and the subsequent surgical interventions.

Firstly, it’s important to understand that hemorrhoid surgery, including procedures like circular stapled hemorrhoidopexy or traditional excisional hemorrhoidectomy, can lead to various postoperative symptoms. These may include pain, bleeding, and changes in bowel habits. In your case, the intense pain and bleeding you experienced after the second surgery could be attributed to several factors.

One potential issue is the development of anal stenosis, which is a narrowing of the anal canal. This condition can occur after surgical procedures, particularly if there is excessive scarring or if the surgical technique inadvertently causes narrowing. The fact that you experienced significant pain during examinations suggests that the anal canal may have been compromised, leading to discomfort during bowel movements.

The presence of a retained surgical instrument, such as a needle, is another serious concern. If this was indeed the case, it could have caused localized irritation and pain, as well as potential infection or inflammation in the surrounding tissues. The removal of the needle during your subsequent surgery likely alleviated some of the discomfort you were experiencing.

Regarding your question about the timeline of symptoms, it is indeed possible for a retained foreign body to remain asymptomatic for an extended period. However, the stress of a subsequent surgery, changes in tissue dynamics, or even the healing process could have triggered the onset of symptoms that were previously unnoticed.

To address your ongoing discomfort, it is crucial to follow up with a healthcare provider who specializes in colorectal surgery. They can conduct a thorough examination, possibly including imaging studies, to assess the condition of the anal canal and surrounding tissues. Depending on the findings, treatment options may include:
1. Dietary Modifications: Increasing fiber intake and ensuring adequate hydration can help soften stools and reduce straining during bowel movements, which is essential for recovery.

2. Medications: Over-the-counter pain relief medications, topical anesthetics, or stool softeners may provide symptomatic relief.

3. Physical Therapy: Pelvic floor therapy can help strengthen the muscles around the anal canal and improve bowel function.

4. Surgical Revision: If anal stenosis or other complications are confirmed, a surgical procedure may be necessary to correct the issue.

5. Regular Follow-Up: Continuous monitoring with your healthcare provider can help catch any complications early and adjust treatment as necessary.

In conclusion, your experience underscores the complexities of postoperative recovery after hemorrhoid surgery. It is essential to communicate openly with your healthcare provider about your symptoms and concerns. They can guide you through the recovery process and help you find the most effective solutions to alleviate your discomfort. Remember, recovery can take time, and addressing any underlying issues is crucial for long-term relief.

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