Post-Surgery Infections After Hemorrhoid Removal

Infection after mole removal surgery?

Hello! I underwent traditional excision surgery for anal warts on September 17, and now, two months later, I still experience pain and bleeding during bowel movements despite soaking in warm water 2-3 times daily.
I initially thought the pain was due to the unhealed internal wart site.
Today, during my follow-up appointment, the doctor found swelling at the suture site, indicating an infection and inflammation, and suspected an anal fistula.
I was prescribed anti-inflammatory medication for two days, and if there is no improvement, I may need a local anesthetic injection to clear the infection.
After returning home, I noticed a hard feeling at the suture site.
I would like to ask: 1.
Can inflammation and infection from wart excision surgery lead to an anal fistula? 2.
If the anti-inflammatory medication is effective, can we rule out the possibility of an anal fistula, and will it not recur? 3.
If a local anesthetic is used to clear the inflammation and infection, does that mean I will need surgery for the anal fistula? Will I have to go through the recovery process from the wart excision again? I have already endured two months of pain since the anal surgery, so I feel very anxious!

Ariel, 40~49 year old female. Ask Date: 2015/11/16

Dr. Ke Fangxu reply Surgery

1.
Although the probability is low, there is indeed a possibility.

2.
An anal fistula is a complication that arises after an infection in the anal region.
If the source of infection is cleared promptly, the likelihood of developing a fistula is reduced, but it is not absolute.
Now that the infection has occurred, the focus should be on effectively treating and eliminating the infection.
Whether it will develop into a fistula in the future will need to be observed over time.

3.
The approach for the second surgery will depend on the depth and extent of the infection.
Whether it involves a fistula or hemorrhoid surgery cannot be determined at this moment.
The physician will likely assess the changes after medication treatment and provide you with a detailed explanation.

Reply Date: 2015/11/16

More Info

Post-surgery infections, particularly after hemorrhoid removal, can be a significant concern for patients. Your experience of ongoing pain, bleeding, and swelling at the surgical site two months post-operation suggests that there may be complications that need to be addressed. Let’s break down your questions and provide a comprehensive understanding of the situation.

1. Can inflammation and infection from hemorrhoid surgery lead to anal fistula?
Yes, inflammation and infection at the surgical site can potentially lead to the development of an anal fistula. An anal fistula is an abnormal connection between the anal canal and the skin surrounding the anus, often resulting from an infection that creates an abscess. If the infection from the surgery is not adequately managed, it can lead to the formation of a fistula. Symptoms of a fistula may include persistent drainage, pain, and swelling around the anus, which could explain the hard feeling you are experiencing at the suture site.

2. If anti-inflammatory medication is effective, can we rule out an anal fistula?
While effective anti-inflammatory medication may reduce symptoms and inflammation, it does not definitively rule out the presence of an anal fistula. If the medication alleviates the pain and swelling, it may indicate that the infection is under control, but it does not guarantee that a fistula is not present. Continuous monitoring and follow-up with your healthcare provider are essential. If symptoms persist or worsen, further evaluation, including imaging studies or examination under anesthesia, may be necessary to confirm or rule out a fistula.

3. If local anesthesia is used to clear the infection, does that mean it is an anal fistula surgery? Will I have to go through the recovery process again?
The use of local anesthesia to address an infection does not automatically mean that you will undergo surgery for an anal fistula. The procedure may involve draining an abscess or cleaning the infected area, which can be done without creating a fistula. However, if a fistula is confirmed during this procedure, then surgical intervention may be required to repair it. This could involve a more extensive recovery process similar to your initial surgery. It is understandable to feel anxious about the prospect of additional surgery, especially after enduring two months of discomfort.

In summary, it is crucial to maintain open communication with your healthcare provider regarding your symptoms and treatment options. If you are experiencing persistent pain, swelling, or any new symptoms, do not hesitate to seek further medical advice. Early intervention can prevent complications and improve your recovery experience. Additionally, consider discussing your concerns about the recovery process and any fears you may have with your doctor, as they can provide reassurance and guidance tailored to your specific situation.

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