Going Home (Outpatient Discharge)
The day of surgery
- Once home, rest for the remainder of the day of your surgery. Do not sit on a "donut".
- On the day after surgery, you may be up and about without any restrictions. Work can be resumed whenever you want to - walking, straining and heavy lifting will not be harmful. Car or plane travel will likewise be safe.
Call the office within a day or so and make an appointment to be seen approximately three weeks after your surgery. The surgical area needs to heal a bit and become less sensitive to make examination more comfortable.
Eat 3 regular meals a day. Drink at least 3 glasses of water daily in addition to your regular beverages.
Take pain medication as prescribed. There is no virtue in trying to "tough it out" without medication.
It is most helpful to take TWO kinds of pain medicine:
- A "non-steroidal anti-inflammatory agent" such as ibuprofen (Advil, Motrin) or naproxen (Aleve, Naprosyn) to minimize inflammation and pain. We recommend ibuprofen 3 tablets (a total of 600 mg) every 6 hours, whether or not you have pain, for a week or two, until your pain is minimal. The object of this is to keep the pain away, rather than waiting for the pain to build up and then try to make it go away. These medications do not require a prescription, and should be purchased in any drug store or supermarket.
- You will receive a prescription for a narcotic pain medication. This should be taken every 3-4 hours as needed for pain. Narcotic medication can cause constipation and other side effects. Taking a "non-steroidal" medication, as recommended above, will likely decrease the amount and length of time you require narcotic pain medicine, and reduce the side effects of these medications.
Take a "bulk laxative" such as Fibercon or Konsyl (calcium polycarbophil), or Metamucil or Citrucel, once daily for the first three weeks after surgery, following the directions on the package.
Move your bowels normally when you feel the urge. Straining is not harmful. It is important to resume your normal habit of bowel movements. Narcotic-type pain medicine, as well as pain itself, will tend to make you constipated if your surgery has been extensive. If you have not had a bowel movement by 2 days after your surgery, take 2 tablespoons of Milk of Magnesia twice a day until your bowels move. If there is still no bowel action by 3 days after your surgery, call the office for further instructions.
Take a "sitz bath", soaking the anal area in plain warm water, for 20 minutes, 2 to 3 times a day for the first week; after the first week, do this once or twice a day until complete healing has occurred. If a tub is not convenient, you may purchase a disposable plastic sitz bath. These are available at most pharmacies and are often more convenient using less water than a conventional tub. Swimming in a pool, lake or ocean, or use of a hot tub, are not harmful.
Urination After Surgery
Stimulation of the pain nerves around the anus by surgery can cause the bladder not to work properly for a short time after surgery. The more extensive the surgery, the more likely this is to be noticeable. If you experience trouble urinating, sit in a sitz bath or tub of warm water. Urinating while in the tub is usually much easier and is not harmful to the operated area. In rare cases, patients may need a catheter (a tube inserted into the bladder) to allow the urine to come out. It may even be necessary to leave such a tube in place for 24 to 48 hours. In these situations, such a maneuver is not harmful nor particularly uncomfortable, but may be a minor temporary nuisance. If you are unable to urinate even after trying the sitz bath/tub routine, please call your doctor to arrange to go to the Emergency Room for the insertion of a catheter.
Mini or Max Pad to keep underclothes from becoming soiled
A loosely applied piece of gauze or a cotton pad is a convenient dressing, as is a "Mini or Maxi Pad." These can be held in place with jockey shorts or panties. The purpose of a dressing is only to keep the underclothes from becoming soiled - it will not be necessary to protect the area of surgery.
Heavy bleeding after anorectal surgery is very uncommon. If you think that you are bleeding excessively, call our office at (206) 386-6600.