Recovery After Sphincter Relaxation Surgery: FAQs and Insights

Self-funded use of tissue aggregation instruments for sphincter relaxation?

Two days before the Lunar New Year, I underwent a procedure using a self-funded tissue coagulation device for anal sphincter relaxation due to intermittent anal fissures.
After the surgery, I took softeners, pain relievers, and enzymes for about ten days, and I noticed an improvement in my bowel movements, which no longer required excessive straining like before.
However, sometimes I feel a sensation of something leaking from the surgical site.
Recently, I've been experiencing pain at the wound site again (sharp pain and some swelling when not having a bowel movement), and at times the pain is severe enough that I need to take pain medication (there's only slight swelling and pain during bowel movements).
During my follow-up appointment, the doctor said everything looked fine and that the pain is likely from the healing process.
I would like to ask the doctor if this type of procedure involves suturing? How long does it typically take for the wound to heal completely with this method? Does the tissue coagulation from the device also require a gradual recovery like a regular injury? If the pain persists beyond what duration should it be considered abnormal? (I am concerned about the possibility of developing a fistula.) I kindly request the doctor to address these questions.
Thank you.

feng, 40~49 year old female. Ask Date: 2016/03/07

Dr. Xu Kaixi reply Surgery

Using Ligasure for hemorrhoid surgery, if the wound is smaller and less severe, suturing may not necessarily be performed.
If there are no other complications, the healing time for such wounds (including the surrounding normal mucosal tissue) is approximately two to four weeks.
The pain associated with the wound is classified as neuropathic pain, and the time for improvement varies from person to person, generally taking longer than the wound healing itself.
The likelihood of developing a fistula is low.

Reply Date: 2016/03/07

More Info

After undergoing sphincter relaxation surgery, it's understandable to have concerns about recovery, especially when experiencing pain or discomfort. Here’s a comprehensive overview of what you might expect during your recovery process, along with answers to your specific questions.

Understanding Recovery After Sphincter Relaxation Surgery
Sphincter relaxation surgery is typically performed to alleviate issues such as anal fissures, which can cause significant pain and discomfort during bowel movements. The procedure may involve techniques that do not require traditional suturing, such as the use of tissue coagulation devices. This can lead to a different healing process compared to conventional surgical methods.

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Pain Management and Recovery Timeline
1. Postoperative Pain: It is common to experience pain after surgery, especially in the initial weeks. The pain may vary in intensity and can be exacerbated during bowel movements. The fact that you are experiencing a "flowing" sensation and intermittent pain is not unusual. This could be due to the healing process, where the tissues are still sensitive and adjusting post-surgery.

2. Use of Pain Medication: Continuing to use pain relief medication as prescribed is important. If the pain becomes unmanageable or if you find yourself needing to take pain medication more frequently, it’s crucial to communicate this with your healthcare provider.

3. Healing Time: Generally, the healing process after sphincter relaxation surgery can take several weeks to a few months. The initial healing phase may last about 4 to 6 weeks, but complete recovery can take longer, especially if there was significant tissue manipulation during the procedure.
4. Signs of Complications: While some discomfort is expected, you should monitor for signs of complications. If you experience severe pain that does not improve with medication, significant swelling, or any unusual discharge from the surgical site, it’s essential to seek medical advice. Persistent pain beyond the expected recovery timeline (typically more than 6 weeks) should be evaluated by a healthcare professional.

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Surgical Technique and Recovery
1. Suturing: Depending on the specific technique used during your surgery, there may or may not be traditional sutures involved. Many modern techniques, including those using coagulation devices, may not require sutures, as the tissue is sealed through the coagulation process. This can lead to a different recovery experience, often with less scarring but potentially more sensitivity during the healing phase.

2. Tissue Recovery: The tissue that has been treated with coagulation will also require time to heal. Just like any surgical procedure, the body needs time to regenerate and repair the affected tissues. This process can be gradual, and patience is key.

3. Follow-Up Care: Regular follow-up appointments with your surgeon are crucial. They can assess your healing progress and address any concerns you may have. If you feel that your recovery is not progressing as expected, do not hesitate to reach out for further evaluation.

Conclusion
In summary, while some pain and discomfort are normal after sphincter relaxation surgery, it’s important to stay vigilant about your symptoms. The healing process can vary significantly from person to person, and factors such as the surgical technique used and your overall health can influence recovery time. If you have any concerns about your pain levels or the healing process, it is always best to consult with your healthcare provider for personalized advice and treatment options. Remember, your comfort and health are paramount, and proactive communication with your medical team is essential for a smooth recovery.

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