Sphincter, Surgery FAQ - Page 4

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Addressing Anal Stenosis: Surgical and Self-Treatment Options

Anal stenosis issue Hello doctor, I am a member of the LGBTQ+ community. I previously underwent fistula and hemorrhoid surgery at another clinic, but since the surgery, I have found it difficult to engage in anal intercourse, and it feels much narrower than before. The previous p...


Dr. Zhang Shuhao Reply:
After surgery for fistulas and hemorrhoids, the wound area may slightly lose elasticity; however, if the external anal sphincter is not damaged, it will not cause severe stenosis. Mild stenosis can be improved through self-dilation, but it is important to ensure adequate lubricat...

[Read More] Addressing Anal Stenosis: Surgical and Self-Treatment Options


Understanding Thrombosed External Hemorrhoids: Treatment Options Explained

Thrombosed external hemorrhoid Hello, doctor. I would like to ask about your previous responses, which mostly mentioned that thrombosed external hemorrhoids can be treated with topical medications and warm sitz baths, and that they will resolve on their own. However, I have also ...


Dr. Ke Fangxu Reply:
Small thrombosed external hemorrhoids can be managed conservatively and may resolve on their own. However, larger thrombosed hemorrhoids may require surgical excision to prevent potential damage to the anal sphincter. The decision on whether to excise or manage conservatively sho...

[Read More] Understanding Thrombosed External Hemorrhoids: Treatment Options Explained


Understanding Post-Surgical Healing: Managing Skin Issues Around the Anus

Supplementary question: Depression of the perianal skin after healing? Hello Dr. Ke: I forgot to mention last time that after using hemorrhoid ointment for several months, I developed inflammation on the skin, resulting in a wound located in the triangular area near the perineal ...


Dr. Ke Fangxu Reply:
If skin inflammation is caused by the excessive use of an ointment, the hemorrhoid cream should no longer be used. The focus should be on treating the dermatitis, which may include both oral and topical medications. It is advisable to consult a physician for evaluation and prescr...

[Read More] Understanding Post-Surgical Healing: Managing Skin Issues Around the Anus


Managing Post-Surgical Scar Indentation and Pain: Solutions and Insights

Depression of the perianal skin after healing? Previously, I had an anal fissure that led to prolonged sitz baths and the use of hemorrhoid ointments for several months, which resulted in severe dermatitis and skin breakdown. When I visited the hospital, they advised me to discon...


Dr. Ke Fangxu Reply:
In theory, once an anal fissure heals, there should be no pain unless it is due to pre-existing chronic fissures caused by excessive sphincter contraction. If the pain is intolerable and affects daily activities, one can try using rectal suppositories for a period of time. Otherw...

[Read More] Managing Post-Surgical Scar Indentation and Pain: Solutions and Insights


Understanding Painful Bowel Movements and Possible Anal Fissures

Bowel movement issues Hello Doctor, I have been experiencing pain during bowel movements for the past few months, and I have noticed bright red blood at the end of my stool, in the toilet, and on the toilet paper. Could this be an anal fissure? Additionally, a few years ago, I no...


Dr. Zhang Shuhao Reply:
Pain and bleeding during and after bowel movements are typical symptoms of anal fissures, which are caused by hard stools, straining during defecation, and increased tension in the anal sphincter. Over time, the fissure can lead to the formation of a sentinel pile at the anal ope...

[Read More] Understanding Painful Bowel Movements and Possible Anal Fissures


Understanding Hemorrhoids: When to Seek Treatment and Potential Risks

Hemorrhoid issues Hello, Director Ke. I would like to ask: 1. I currently have some tissue around the anal area that looks like hemorrhoids. There is no significant swelling, pain, prolapse, or bleeding, and the sensation of a foreign body is mild. I only experience occasional an...


Dr. Ke Fangxu Reply:
1. Surgery is not necessary for hemorrhoids if there is no persistent bleeding, severe pain, or significant prolapse; most cases can be improved through lifestyle modifications and changes in bowel habits. 2. Hemorrhoids do not progress to rectal prolapse or rectal prolapse. If...

[Read More] Understanding Hemorrhoids: When to Seek Treatment and Potential Risks


Understanding Anal Fissures: Causes, Treatments, and Relief Tips

Anal fissure issues? Hello, doctor. I have had an anal fissure for the past few days and have several questions: 1. What could be the reason for developing an anal fissure even though my stool is not particularly hard or large? Could it be due to excessive sphincter muscle tens...


Dr. Chen Bingze Reply:
Hello, I understand this issue must be very troubling for you. 1. Typically, increased anal sphincter pressure is a concern. It is recommended to take a warm sitz bath for fifteen minutes daily. 2. If the stool is hard and bulky, it may be difficult to pass. Increasing your wa...

[Read More] Understanding Anal Fissures: Causes, Treatments, and Relief Tips


Understanding Anal Fissures: Causes, Symptoms, and Treatment Options

Causes, Symptoms, and Management of Anal Fissures Hello, doctor. I usually have a healthy diet, and my bowel movements are mostly normal, but I occasionally experience anal fissures (not often; the last occurrence was two to three months ago). I have a few questions: 1. What co...


Dr. Zhang Shuhao Reply:
1. One of the causes of anal fissures is excessive tension in the sphincter muscle, so sphincterotomy can be used as a treatment. 2. Soaking in warm water and relaxing can be effective; if medication is needed, it is recommended to obtain a prescription from a doctor rather than ...

[Read More] Understanding Anal Fissures: Causes, Symptoms, and Treatment Options


Managing Chronic Anal Fissures: Effective Solutions and Concerns

Recurrent anal fissures? I have been experiencing recurrent anal fissures for almost two years now. Each time they occur, they heal within a few days, averaging about once a month. They usually happen when my stools are relatively large and hard, and seeing them makes me feel ver...


Dr. Zhang Shuhao Reply:
1. The best way to improve the situation is to avoid constipation, allowing the wound to heal completely. Increasing fluid and dietary fiber intake, taking warm sitz baths, and avoiding excessive straining during bowel movements can help. 2. If the wound has not healed after eigh...

[Read More] Managing Chronic Anal Fissures: Effective Solutions and Concerns


How to Prevent and Manage Anal Fissures and Related Symptoms

How to improve or prevent anal fissure bleeding? Hello, Doctor. (1) A few years ago, I had anal fissures and hemorrhoids and received treatment at the hospital, and I have since recovered. However, I have noticed that during anal intercourse with my partner, there is a high likel...


Dr. Zhang Shuhao Reply:
1. If you have previously experienced anal fissures, it is essential to use ample lubrication and gradually dilate the anus before anal intercourse. Insertion should only occur when the anal sphincter is completely relaxed. If you experience sharp pain during the process (the pai...

[Read More] How to Prevent and Manage Anal Fissures and Related Symptoms


Understanding Complications After Minimally Invasive Surgery: A Case Study

Failed laparoscopic tubal ligation surgery? On September 29, 2022, surgery was performed (the doctor mentioned that the drain was very thick and hard). I was discharged home on September 30 but had a low fever. On October 1, I noticed a large amount of pus draining (the fever sub...


Dr. Zhang Shuhao Reply:
The minimally invasive fistulotomy procedure referred to is the LIFT (Ligation of the Intersphincteric Fistula Tract) surgery. This technique is suitable for cases where the fistula is intact and the internal and external openings are clearly defined. In cases of severe inflammat...

[Read More] Understanding Complications After Minimally Invasive Surgery: A Case Study


Understanding Anal Sphincter Dysfunction After Childbirth and Surgery

Sphincter muscle weakness or injury Hello Doctor, I have been experiencing scar pain, a foreign body sensation, fecal incontinence, and leakage after bowel movements since undergoing hemorrhoid surgery postpartum. After undergoing anorectal manometry and anal ultrasound, the do...


Dr. Zhang Shuhao Reply:
1. Training the pelvic floor muscles and conservative treatments such as physical therapy have about a 60% chance of improvement. 2. If conservative treatments are ineffective, sphincter repair surgery is still recommended. Even if the remaining muscle strength is insufficient,...

[Read More] Understanding Anal Sphincter Dysfunction After Childbirth and Surgery


Understanding Anal Sphincter Issues After Hemorrhoid Surgery

Sphincter issues Hello, doctor. I am the patient from case #188320 regarding post-operative hemorrhoids and anal sphincter weakness. I had my hemorrhoid surgery at Taichung Medical Center, where the surgeon informed me after reviewing my MRI that one side of my anal sphincter is ...


Dr. Zhang Shuhao Reply:
1. The perineal nerve is responsible for the sensory and motor functions of the sphincter muscles and the anal canal. To diagnose incontinence caused by sphincter dysfunction, it is essential to rule out any issues related to nerve sensory abnormalities. 2. You can consult other ...

[Read More] Understanding Anal Sphincter Issues After Hemorrhoid Surgery


Understanding Discomfort Around the Anus: Causes and Solutions

There is a soreness in a specific area around the anus? Yesterday, after having a bowel movement, I didn't feel much. However, after sitting in my room, I started to feel a soreness around the area near my anus. When I pressed on it, I found a point that felt sore when press...


Dr. Zhang Shuhao Reply:
The cause of localized soreness may be due to injury or fatigue of the sphincter muscle. A small percentage may be attributed to deeper anal abscesses, which may not be visible externally but present as soreness. It is recommended to take warm sitz baths to help relax, avoid cons...

[Read More] Understanding Discomfort Around the Anus: Causes and Solutions


Chronic Anal Fissures: Impact on Bowel Health and Healing

Anal fissure. Bowel habits? 1. Based on your description, it sounds like you may be experiencing chronic anal fissures. Chronic anal fissures are defined as fissures that persist for more than eight weeks and can cause recurring pain and discomfort. 2. If the fissures have not h...


Dr. Zhang Shuhao Reply:
Acute anal fissures typically heal within about a week if the wound is allowed to rest properly. However, if the affected area is repeatedly injured and symptoms persist for more than six weeks, it is classified as a chronic anal fissure. This may be due to tight anal sphincter m...

[Read More] Chronic Anal Fissures: Impact on Bowel Health and Healing


Post-Surgery Anal Stenosis: Managing Pain and Leakage After Treatment

Post-mole excision? Hello Doctor, I underwent ultrasound knife surgery on July 26. Due to pain and difficulty during bowel movements, a month and a half later, the surgeon diagnosed me with anal stenosis and performed anal dilation. For the past month, the doctor has instructed m...


Dr. Ke Fangxu Reply:
If the anal stenosis is not severe, the anal sphincter may potentially return to normal. However, if the stenosis is severe enough that it cannot be resolved through sphincter function or if there are recurrent episodes of stenosis with pain, surgical intervention such as analopl...

[Read More] Post-Surgery Anal Stenosis: Managing Pain and Leakage After Treatment


Understanding Seton Management Surgery: Potential Complications and Recovery Insights

Anal fistula is a condition that may have potential complications when treated with seton management surgery? Dear Director Ke, I have an anal fistula that began treatment with a seton placement surgery on February 25, 2022. One-third of the fistula's total length is locate...


Dr. Ke Fangxu Reply:
The indentation and the rubber band should not be related, and there is no reason for it not to heal on its own. It is more likely a remnant left from wound healing. If there is no pain or infection, no special treatment is necessary. If surgical repair is considered, I cannot an...

[Read More] Understanding Seton Management Surgery: Potential Complications and Recovery Insights


Understanding Rectal Discomfort: Risks and Surgical Options

Bowel movement issues Hello Doctor: Recently, I have been experiencing discomfort in my anus after having a bowel movement (it doesn't hurt, but it feels like there's something at the anal opening). I later realized that I had pulled my anal sphincter out, and I managed...


Dr. Zhang Shuhao Reply:
The tissue that protrudes after bowel movements is a prolapsed internal hemorrhoid, which can be manually pushed back into place. Sometimes, taking warm sitz baths can help reduce swelling and improve the condition. If this occurs frequently and causes distress, it is advisable t...

[Read More] Understanding Rectal Discomfort: Risks and Surgical Options


Understanding Painful Bowel Movements: Fissures, Hemorrhoids, or Polyps?

Is pain during bowel movements a sign of anal fissure? Hello, doctor. I have both internal and external moles, and I have coexisted with them peacefully for a long time. However, after experiencing constipation and passing hard stools, I now have sharp pain during each bowel move...


Dr. Zhang Shuhao Reply:
Pain during or after bowel movements that feels like a knife cutting is a typical symptom of anal fissures. This is caused by tension in the sphincter muscle or excessive straining during defecation, leading to a tear. Some anal fissures may be accompanied by symptoms such as ana...

[Read More] Understanding Painful Bowel Movements: Fissures, Hemorrhoids, or Polyps?


Post-Surgery Recovery: Can You Masturbate Without Causing Bleeding?

When bleeding occurs, it is necessary to apply pressure with a gauze to stop the bleeding? Hello, doctor. I would like to ask if I need to wait until I am completely healed before engaging in masturbation. Since my discharge, I have masturbated twice, and both times I experienced...


Dr. Zhang Shuhao Reply:
During ejaculation, the contraction of the entire pelvic floor muscles can lead to the contraction of the external sphincter; however, this rarely causes direct bleeding from a wound. If bleeding persists, it is advisable to return for a follow-up examination of the wound. In the...

[Read More] Post-Surgery Recovery: Can You Masturbate Without Causing Bleeding?


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