Post-Surgery Concerns: Managing Discomfort After Mixed Nevus Removal

After the mixed nevus surgery in early September this year, a small lump can be felt near the anus?

Hello Doctor, after my mixed nevus surgery in early September, I have been following the instructions and taking warm sitz baths regularly, which has helped with recovery.
However, I can still feel a small bump near the anal area, especially noticeable when I wash up after work each day.
The swelling seems to reduce more when I take a warm sitz bath.
In early November, I ate some election-related food that upset my stomach, leading to constipation and diarrhea for about one to two weeks, which caused discomfort in the anal area.

In mid-November, during a follow-up appointment, the doctor mentioned that my anal discomfort was not due to constipation.
He advised me to buy some over-the-counter medication to apply.
I felt a bit anxious and asked the doctor why I could still feel a small bump at the anal opening.
He replied that no surgery is perfect.
I then asked if the swelling would eventually go down, and he said it might not, but there is a possibility it could reduce.

Currently, I still check the area after my morning bowel movement and again after work around six in the evening.
It feels more swollen in the evening, and I find that sitting in a warm sitz bath for about ten minutes helps reduce the swelling a bit.
I am quite troubled by why I still need to take sitz baths daily for comfort after the surgery.

On December 20, after using the restroom and taking a warm sitz bath, I still felt discomfort.
After my afternoon shower, I applied a bit of the "Xiyu Zhi" ointment.
This morning, after using the restroom and taking a warm sitz bath, the discomfort was less than yesterday.

Doctor, should I continue using the "Xiyu Zhi" ointment? How long should I keep applying it? I make sure to drink plenty of water, walk regularly, and avoid sitting for long periods.
What else can I do to improve my condition so that I don’t need to take sitz baths and my anal area feels comfortable? Thank you.

Ling, 20~29 year old female. Ask Date: 2014/12/21

Dr. Xu Kaixi reply Surgery

After hemorrhoid surgery, once the wound at the anal opening has healed, there may be varying degrees of scarring and fibrous tissue formation depending on the severity of the hemorrhoids prior to surgery.
When these postoperative changes are more pronounced, patients may feel protrusion or swelling at the anal area.
Applying anti-inflammatory or hemorrhoid ointments, or taking warm sitz baths to promote circulation, can help alleviate discomfort.
The duration for complete improvement varies from person to person, and it is recommended to visit a surgical outpatient clinic for further examination and assessment.

Reply Date: 2014/12/21

More Info

After undergoing surgery for a mixed nevus removal, it is not uncommon to experience discomfort and other post-operative symptoms. Your concerns about the persistent discomfort around the anal area, the presence of a small lump, and the need for regular sitz baths are valid and warrant further discussion.

Firstly, it is important to understand that surgical procedures, even minor ones, can lead to various outcomes, including swelling, tenderness, and the formation of scar tissue. The lump you are feeling may be a small amount of residual tissue or scar tissue that can develop after surgery. This is not unusual, and while it may be concerning, it is often a part of the healing process. The fact that your doctor mentioned that "no surgery is perfect" aligns with the reality that some degree of irregularity can occur post-operatively.

The need for sitz baths is a common recommendation after surgeries involving the anal area. These baths help to soothe the area, reduce swelling, and promote healing by increasing blood flow to the region. The warmth of the water can also provide relief from discomfort and help with any inflammation. It is understandable that you find relief from sitz baths, and it is advisable to continue this practice as needed, especially if it helps alleviate your symptoms.

Regarding your experience with gastrointestinal issues, such as constipation or diarrhea, these can indeed contribute to discomfort in the anal area. Straining during bowel movements can exacerbate any post-surgical sensitivity or swelling. It is good to hear that you are focusing on hydration and regular movement, as these are essential for maintaining healthy bowel function. Increasing fiber intake through fruits, vegetables, and whole grains can also help prevent constipation.

As for the "喜癒痣" ointment you mentioned, it is crucial to follow your doctor's advice regarding its use. If your doctor recommended applying it, it may be beneficial to continue using it until you see a significant improvement or until your doctor advises otherwise. The ointment may help with healing and reducing any discomfort or irritation.

To improve your overall comfort and potentially reduce the need for sitz baths, consider the following tips:
1. Maintain Hydration: Continue to drink plenty of water to keep your stools soft and prevent constipation.

2. Dietary Adjustments: Incorporate high-fiber foods into your diet to promote regular bowel movements. Foods such as fruits, vegetables, whole grains, and legumes are excellent choices.

3. Regular Exercise: Engage in light physical activity, such as walking, to stimulate bowel function and improve circulation.

4. Avoid Straining: When using the bathroom, try to relax and avoid straining. If you find yourself constipated, consider using a stool softener or a gentle laxative after consulting with your doctor.

5. Monitor Symptoms: Keep track of any changes in your symptoms, including the size of the lump and any discomfort. If you notice worsening symptoms or new concerns, do not hesitate to reach out to your healthcare provider.

6. Follow-Up Appointments: Ensure you attend all follow-up appointments with your doctor to monitor your healing process and address any ongoing concerns.

In conclusion, while it is normal to experience some discomfort and irregularities after surgery, maintaining good bowel habits, using recommended ointments, and continuing with sitz baths as needed can significantly aid in your recovery. If you have any further concerns or if your symptoms persist, it is essential to communicate openly with your healthcare provider for tailored advice and potential interventions.

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