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Anal Stenosis After Hemorrhoidectomy: Avoidance and Management

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Gastrointestinal Surgery

Abstract

Hemorrhoidal disease is a very common problem, affecting a large number of patients. The majority of patients with hemorrhoids can be managed nonoperatively; however, for patients who fail nonoperative therapy, hemorrhoidectomy is a safe and effective option. Anal stenosis is an uncommon complication after hemorrhoidectomy, but can be a potentially debilitating condition. The majority of patients with anal stenosis can be managed nonoperatively with a combination of stool bulking agents, stool softeners, increased fluid intake, and, occasionally, anal dilation. If patients fail nonoperative management, there are multiple options for surgical therapy including sphincterotomy, rectal mucosal flap reconstruction, and perianal tissue flaps. When choosing the surgical approach to anal stenosis, it is important to appropriately diagnose the level of stenosis and determine whether the patient has a functional, anatomic, or combined stenosis.

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Authors and Affiliations

  1. Department of Surgery, Barnes-Jewish Hospital, Washington University, St. Louis, MI, USA

    Mitchem Jonathan B. MD

  2. Department of Surgery, Section of Colon and Rectal Surgery, Barnes-Jewish Hospital, Washington University, St. Louis, MI, USA

    Asst. Prof. Paul E. Wise

Authors
  1. Mitchem Jonathan B. MD
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  2. Asst. Prof. Paul E. Wise
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Correspondence to Paul E. Wise .

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Editors and Affiliations

  1. Division of Surgical Oncology, Johns Hopkins Hospital, Baltimore, Maryland, USA

    Timothy M. Pawlik

  2. Division of Surgical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia, USA

    Shishir K. Maithel

  3. Professor of Surgery, Division of Surgical Oncology, University of Miami, Miller School of Medicine, Sylvester Comprehensive Cancer Center, Miami, Florida, USA

    Nipun B. Merchant

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Jonathan B., M., Wise, P. (2015). Anal Stenosis After Hemorrhoidectomy: Avoidance and Management. In: Pawlik, T., Maithel, S., Merchant, N. (eds) Gastrointestinal Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2223-9_44

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  • DOI: https://doi.org/10.1007/978-1-4939-2223-9_44

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-2222-2

  • Online ISBN: 978-1-4939-2223-9

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