Anal Granules: Questions on Diagnosis and Treatment

Q: Anal Granules: Questions on Diagnosis and Treatment

1. <br>If it has been present since June and is too small to send for a pathological specimen, the likelihood of it being something other than condyloma acuminatum is greater, as condyloma acuminatum is a rapidly growing condition that typically reaches a size suitable for examin

Anal granules

Thank you very much, Dr.
Ke, for your response, but I still have many questions >_< When I visited the large hospital last time, the doctor conducted a physical examination but could not confirm anything, so he suggested that the quickest method would be to go to the operating room and use instruments to open it up for a clear view.
If it is indeed a problem, they would directly use electrocautery to treat it; if not, they would leave it alone.
Therefore, yesterday, I also went to the operating room.
After the doctor examined me, he said it looked somewhat like it, so he directly burned it off.
However, he mentioned that the lesions were very small, only three points, so after the procedure, he did not prescribe any topical ointment, only oral medication.
There were no instructions like applying adhesive bandages or packing with gauze, and no specimens were sent for testing because they were too small.
He said he was concerned that cutting them out would cause me more pain.
My questions are:
1.
I noticed those lesions back in June.
If they are indeed warts, is it possible for them to remain this small and not multiply after two to three months without any treatment?
2.
Although the doctor did not prescribe any ointment for me, my wound has been a bit painful these past two days.
Can I apply something like Mupirocin or Neosporin to help the wound heal faster?
3.
The doctor said my hemorrhoids are at stage three, which is considered severe, and he recommended surgery.
However, I recall Dr.
Ke mentioning in previous responses to other patients that if surgery can be avoided, it should be.
At what point (in terms of physical symptoms) should stage three hemorrhoids definitely require surgery? (Before the electrocautery, I was taking fiber prescribed by another colorectal doctor, and I have been having daily bowel movements without bleeding.)
4.
Since no specimens were sent for testing, I cannot confirm whether it is warts.
If it is, how can I ensure that there is no recurrence? >_< I know I have many questions, and they may seem a bit stupid, but sometimes the thought of possible recurrence and unexplained infections really makes me very sad and worried.
So, I truly appreciate Dr.
Ke for patiently responding each time; my gratitude cannot be expressed in just a few words.
Wishing you all the best.

BB, 20~29 year old female. Ask Date: 2014/10/07

Dr. Ke Fangxu reply Surgery

1.
If it has been present since June and is too small to send for a pathological specimen, the likelihood of it being something other than condyloma acuminatum is greater, as condyloma acuminatum is a rapidly growing condition that typically reaches a size suitable for examination within three months.

2.
After electrosurgery, the wound can be treated with Neomycin ointment; however, it contains menthol, which may irritate the wound and hinder healing.

3.
For hemorrhoids, if there is no bleeding, pain, or prolapse, I personally do not recommend surgical treatment, as the symptoms are not severe, and the significance of surgery would be minimal.
However, this is just my personal opinion, and different physicians may have varying views.

4.
Currently, since the specimen can no longer be submitted for examination, it is essentially an unresolved issue.
However, as long as there is no recurrence within 1-3 months, it is unlikely to come back.

Reply Date: 2014/10/07

More Info

Understanding anal granules, particularly in the context of potential diagnoses such as condyloma acuminatum (commonly known as genital warts), can be a source of anxiety for many patients. Your concerns are valid, and it's important to address them comprehensively.

1. Stability of the Granules: If the granules you observed in June remained small and did not multiply over the course of two to three months, it is possible that they are not condylomas. Condylomas typically grow and can multiply if left untreated. However, individual responses can vary, and some lesions may remain stable for extended periods. It’s also worth noting that not all anal granules are warts; they can be benign lesions or other skin conditions. The fact that your doctor chose to treat them with electrosurgery suggests a suspicion of a viral etiology, but the small size and lack of growth could indicate a benign nature.

2. Post-Operative Care: Regarding the pain at the surgical site, it’s crucial to follow your doctor’s advice. While over-the-counter topical treatments like Neosporin can be beneficial for minor wounds, you should consult your physician before applying any medication to ensure it won’t interfere with healing or cause irritation. If the pain persists or worsens, it’s essential to reach out to your healthcare provider for further evaluation.

3. Hemorrhoids and Surgical Considerations: You mentioned that your doctor classified your hemorrhoids as third-degree, which typically indicates that they protrude outside the anal canal and may require surgical intervention. The decision to proceed with surgery often depends on the severity of symptoms, such as pain, bleeding, or prolapse. If you experience significant discomfort, recurrent bleeding, or if the hemorrhoids interfere with daily activities, surgical options may be warranted. It’s always best to discuss your symptoms and concerns with your healthcare provider, who can help you weigh the risks and benefits of surgery versus conservative management.

4. Monitoring for Recurrence: Since no tissue was sent for pathological examination, it can be challenging to confirm the nature of the granules. If they were indeed condylomas, regular follow-up is essential. Monitoring for any new growths or changes in the area is crucial. Practicing safe sex, maintaining good hygiene, and discussing vaccination against HPV with your healthcare provider can also help reduce the risk of recurrence. If you notice any new symptoms or changes, such as new growths or persistent pain, you should seek medical advice promptly.

In conclusion, while your concerns are understandable, it’s essential to maintain open communication with your healthcare provider. They can provide personalized advice based on your specific situation and medical history. Regular follow-ups and monitoring are key to managing your health effectively. Remember, you are not alone in this, and seeking support from healthcare professionals is a proactive step towards ensuring your well-being.

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