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psyadam 09-08-2008 08:43 AM

My Recent PPH Surgery Experience
I had the PPH surgery on 27 August 2008. I went in with the expectation of some discomfort and that I'd be back at work in a week or so. I'm 50 with type 3 hems with prolapse. Had the conventional surgery 25 years ago. Surgeon was a colo-rectal specialist with an assistant surgeon as well "to avoid complications."

Surgery was uneventful, home three hours after it completed, some discomfort, taking torodol and percocet for pain. First 72 hours felt pretty good, as expected. After 72 hours, no more torodol (high risks after 72 hours), replaced with motrin. At that point, feeling of pressure, discomfort, horrible bowel movements began.

Surgeon responsive to phone calls, stated that I had "large hems and this kind of discomfort wasn't unusual." Of course, pre-surgery, surgeons push the ease of surgery, post, speak of pain as normal. Seventh, eighth day were pretty horrible, ten/twelve bms/day, not sure why, so most of time between toilet and bathtub to soak and recover from the pain of bms.

Obviously couldn't get back to work that week. Saw surgeon on day 10 for exam, she probed with a finger, too swollen for more. Told me I was pretty swollen, it would be painful, try to reduce the percocet (originally taking two every 4 hours, now 2 every six hours, less than two doesn't seem to take edge off the pain).

Now day 12, still lot of pressure, swelling. Feels like small hem poking out of anus, but could be swelling, not sure. Blood with each bm, some spotting. Latest symptom is this "oozing" of clear fluid, sometimes makes "wet spot" in underwear, almost like a "sweating", but it's always damp. Call into surgeon to see if it's a problem or normal, wasn't informed of this symptom.

I've read these boards, tried different stool softeners (colace, miralax), don't have hard stools, just painful.

So, am i the exception to the pph rule? I have more pain than I had been led to believe and my "down time" is longer than I thought. Is it worth it? Guess I'll know in a few weeks, when the pain subsides/goes away. But, my own conclusion at this point, is that surgery is surgery, painful, takes time to recover. I'm not one of the PPH miracles, one day of discomfort and advil and then back to life. It's worse than I thought, and hopefully I'll look back and be grateful. Happy to answer anybody's questions and love any feedback from anyone else who might have suggestions for me. It really sucks, this recovery process and I have a pretty high tolerance for pain (and pain meds, unfortunately).


psyadam 09-29-2008 01:54 PM

4.5 week follow up on PPH Surgery
It's been four and a half weeks since the PPH surgery. Not needing the Depends anymore, no leakage or blood. Bowel movements are fine. My sleep cycle is still disturbed, get up at 4:30am, but not because of pressure or pain or bm need (just did that for so many weeks, maybe body still remembers it). I still have the discomfort of hemorrhoid pain, still swollen. There is still flesh outside of the anus, which is uncomfortable, retains some fecal material, rubs when I walk. My surgeon is "hopeful" that it will recede as the swelling continues to improve. She wouldn't answer question on whether this will need to be addressed surgically. I used to have prolapse, but it would stay "inside" except for bms. This is outside, too swollen to push inside. To me, this is worse than prior to the surgery. I'm back to work, uncomfortable to sit for more than an hour at a time. Only treatment for this according to doctor is use of ice packs to reduce swelling and keep feet elevated as much as possible. She says I can begin to exercise upper body, and abdominals (unless painful). Can't really do cardio, as the protruding flesh makes it uncomfortable. I'm feeling pessimistic, that the surgery hasn't really helped anything, but still hopeful that in a few more weeks some miracle will happen and all will be well. Not sure if I would have been better off with the conventional surgery, don't think it would have been significantly more painful or disruptive than this one has been.

sweetiepie2008 10-31-2008 07:33 PM

Re: My Recent PPH Surgery Experience
My husband had the PPH surgery Oct 24th. I'm feeling pretty worried at this point. the Pain during BM is so bad. He says out of everything he's experienced it is the worse. They said he has a thrombosis and that it would heal up in a couple of weeks. The pain meds aren't helping. They never told us of this pain and I wish that I would have found this message board before he had this done. Believe me I wold have begged hm not to do it. If anyone is thinking of having this surgery think again. The pain is so horrible. He is not eating just so that he won't have a bowl movement. He goes fromt he toilet to soaking in a tub and the doctor pretty much sent us home to deal with it on our own.

mizzbee 11-02-2008 08:04 PM

Re: My Recent PPH Surgery Experience
After my PPH operation, I experienced a great urgency to defecate on waking and at other times. I had the operation 4½ years ago and that same urgency still plagues me. These days I can make it to the toilet in time but I cannot hold it in for any lengthy period. My operation was only successful for 6 months. I will not personally recommend this form of surgery to anyone.

sweetiepie2008 11-08-2008 07:22 AM

Re: 4.5 week follow up on PPH Surgery
Just wondering how you are doing since surgery. Its been 2 weeks for my husband and he is still in much pain and staying in the bathroom a lot. His nurse is very rude to me on the phone and says he should not be in this much pain after 2 weeks and his doctor refuses any more pain pills. I asked her what should we do and she said go to your nearest emergency room. I was dumbfounded.

BadPPH 11-30-2008 08:15 PM

Re: My Recent PPH Surgery Experience
I had the PPH surgery on 9/17/2008 for stage 3 internal and external hemorrhoids. I was told to expect some discomfort. Everyone heals differently they said, some people return to work the next day, some takes a week, some two weeks. Well, it has been almost 11 weeks for me and I am still in terrible pain.

Here's what happened:

They wanted me to have my first BM around day 2 after surgery. So, I took Milk of Magnesia to help with that. That didn't work, so I had to get some stronger laxative stuff from the drugstore. Finally, started having BM's (mostly diarrhea, lots of blood). I was also having lots of pain that the Percocet would not even touch. I can't remember how many nights I slept in the bathtub because that was the only thing that would relieve the burning sensation inside.

I went back for my 3 week checkup and the doctor was concerned with all the swelling and assumed that was the reason for the pain. Right around that time, I started having pretty explosive, loose BM's between 10-15 times per day. This has gone on for approximately 7 weeks and I have lost 15 pounds from it. Surgeon keeps saying it's because everything is so swollen that my intestines cannot hold anything inside.

So, I went for a second opinion a week ago. This doctor thinks that my hemorrhoids are about three times larger than before the operation most likely because of all the bowel movements. The bm's are caused by muscle spasms and they are working to get those under control. After those are under control, this doc is planning to recommend the traditional hemorroidectomy.

I am at my wit's end with this. This has been the worst experience of my entire life. I would not recommend the PPH surgery to anyone. They made it sound like it was such a minimallly invasive, simple procedure. Turns out, after this happened, I have researched so many complications that I would have never agreed to have this done.

Does anyone have any similar stories? Just looking for some advice/comments.

mizzbee 12-01-2008 08:46 PM

Re: My Recent PPH Surgery Experience
I want to know what happens to those staples that the stapling gun uses during the PPH procedure

BadPPH 12-03-2008 09:38 AM

Re: My Recent PPH Surgery Experience
I was told that the staples eventually go away. What surprises me is that they said there are approximately 60-70 staples used for this procedure. I had no idea there were that many. They do not go in and remove them and the doctors are telling me that eventually they come out through bowel movements, months or years later. I am getting ready to have an outpatient procedure under anesthesia so they can check and see why I'm having so many problems 11 weeks later. The doctor said he'll be surprised if I have any of the staples left, so we'll see what happens. Have you had the PPH surgery before?

mizzbee 12-03-2008 10:43 AM

Re: My Recent PPH Surgery Experience
I had my PPH surgery done 4½ years ago. It took 8 weeks for full recovery only to have all my old symptoms reappear 4 months after that. I never had any problems with bowel movements before going for surgery but I now suffer with an urgent need for a bowel movement on waking and at any other time during the day. If there is no toilet nearby, I have a problem. I can only assume that my PPH surgery has left me with some internal damage. This symptom has been reported in other cases.

sweetiepie2008 12-04-2008 04:43 PM

Re: My Recent PPH Surgery Experience
My Husband had this procedure done on October 24th, 6 weeks, The pain is better but he still has lots of gas and the feeling that he has to go most of the time, he’s up and down all night and day. He can’t really go anywhere. He started back to work but has terrible gas and back and forth to the bathroom. When he does go there is lots of burning. This has been a nightmare for us as well. I'm in agreement if I had done more research and found these Message boards I would have encouraged him not to do it. The doctor just handed us the brochure and we looked on the website and it looked like an easy procedure. After 3 weeks of unmanageable pain the doctor pretty well just left us to cope with this on our own. Saying “you shouldn’t be in this much pain” and “everything looks normal”. Well it’s not normal and I am hoping and praying he will just be able to stay at work 8 hours a day.

mizzbee 12-04-2008 09:28 PM

Re: My Recent PPH Surgery Experience
Although I have nothing good to say about the PPH surgery, things do get better. I also had many trips to the toilet, up to 15 times a day, for about a year. The constant ache prior to my BM’s was depressing but I obtained relief for about 20 minutes after each BM. I then followed the advice found on this website about Psyllium. This has made the frequency of my BM’s manageable and I no longer have that awful aching feeling, unless I forget to take my Psyllium. It may also help your husband.

mecho 12-18-2008 11:45 AM

Re: My Recent PPH Surgery Experience
[QUOTE=sweetiepie2008;3812955]My Husband had this procedure done on October 24th, 6 weeks, The pain is better but he still has lots of gas and the feeling that he has to go most of the time, he’s up and down all night and day. He can’t really go anywhere. He started back to work but has terrible gas and back and forth to the bathroom. When he does go there is lots of burning. This has been a nightmare for us as well. I'm in agreement if I had done more research and found these Message boards I would have encouraged him not to do it. The doctor just handed us the brochure and we looked on the website and it looked like an easy procedure. After 3 weeks of unmanageable pain the doctor pretty well just left us to cope with this on our own. Saying “you shouldn’t be in this much pain” and “everything looks normal”. Well it’s not normal and I am hoping and praying he will just be able to stay at work 8 hours a day.[/QUOTE]

Hi Sweetiepie,
Sorry to hear about your husband's pain, because i can relate to it. I also had a PPH done on December 10th, now i has been 11 days, I still have a lot of soarness in my anal canal. I had a stage 3 hem, and the doctor recommended PPH, and the procedure was done by a rectal-colon specialist from Kaiser. I was told that the recovery depends may take the most about a week. I have been staying home for almost 2 weeks, constantly experienced a lot of pressure in my behind. Urination is difficult too, I had to soak my behind in the warm/hot water, it makes the bm and the urination easier.
I am hoping that I should be recover soon. The PPH procedure was pretty painless and quick, but the pain is pretty excruciating after the surgery.
I hope your husband feel better.

sweetiepie2008 12-21-2008 04:47 PM

Re: My Recent PPH Surgery Experience
Has anyone else experienced black tarry stools after this surgery my husband has had this for 3 weeks and I am concerned

PPHJL 12-23-2008 09:56 PM

Re: My Recent PPH Surgery Experience
I've been reading everyone's comments on their PPH experience, and I've also looked at various other boards as well. I just had PPH surgery along with a sphincterotomy on Friday, December 12, 2008. The PPH was for 3d degree hemorrhoids and the sphincterotomy for a chronic fissure. I've had some degree of hemorrhoids for 13 years, with the 3rd degree for about the past 9 years. I had tried a surgery called DGU (Doppler Guided Ultrasound) in 2001 and that was completely useless. Because of my negative experience with that, I waited nearly 8 years to try something again.

I spoke with my c/r surgeon about surgery and he mentioned a few options. I actually brought up the idea about PPH, and he told me that he did not do it, but he would refer me to a surgeon with extensive experience. After an initial thorough consult, the new c/r surgeon that I went to see agreed that I was a good candidate for PPH. For clarification purposes, I should explain that my 3rd degree consisted of one prolapsed bunch of hemorrhoids along with the chronic fissure. To further complicate matters, I also have bouts of IBS.

Here's my experience so far:
Day 1: The hospital released me roughly 3 hours after surgery. The nurse let me go without me urinating. I felt quite a bit of pressure and discomfort. The painkillers helped. I still hadn't urinated 5 hours after I left the hospital, and I was starting to experience a lot of discomfort in my bladder. Finally, my wife took me to the ER where they had to insert a catheter (top 10 worse experiences of my life) and they were able to relieve the pressure.
I made them remove the catheter once I had drained. After coming home, I needed to literally stand in the shower and run hot water over my genitals every time I felt that I had to urinate...every time. That night, I was up about every hour urinating without the help of the shower. I took Oxycodone, Dulcolax, Colace and a psyllium powder

Day 2: I had my first bowel movement...very uncomfortable. My bowels were spasming before, during and after every bowel movement. I used the sitz bath religiously, sat in hot bathtubs, and continued to stand in the shower when I couldn't urinate on my own. The spasm were the worst part.
At this point, I was convinced I would still make it back to work on Monday.

Day 3: Not loving life, but not hating it. I was still taking pain killers, colace and dulcolax. I thought maybe that was what was causing the cramping and spasms, so I stopped the laxatives. Turns out I was only supposed to take them the first much for clear instructions. Still needed the hot shower to urinate at times, and still relied on sitz baths after every bowel movement. The one major issue with pain killers and this type of surgery is that pain killers inherently cause constipation...terrible combination! I realized this day that I would not be returning to work nearly as quickly as I thought.

Fast forward thru the next week...
Urgeny to have a bowel movement followed by nothing or barely nothing at all. This would happend all day long. This started happening less and less over the next several days. Urination went back to normal. Some normal bowel movements and some not so great. I think my IBS is playing a huge role in this recovery. Right now, my bowel movement are overall ok, but my mornings are not great all. I have to go, or try to go, 4-8 times over a 5 hour period. My rectal area aches for hours afterward. I feel better from about 2:30 PM on...I've had little or no blood in my stool. Tonight, 11 days later, I noticed some blood, but I wiped and there was no more.

My biggest accomplishment was driving from Philadelphia to Arlington, VA (3 hours) and back in the same day, 8 days after surgery. The morning down was not great b/c of what I just explained, but that night driving back felt pretty damn good. I've got a soft perenial pillow that really helps when it is needed.

I really think I am making progress. I have my 2 week follow up next Monday, December 28th (more than 2 weeks, but close enough). The biggest problems are those damn spasms and aches.

I hope this information was helpful.


BadPPH 12-29-2008 09:44 AM

Re: My Recent PPH Surgery Experience
It makes me feel a little better to hear of similar stories. Josh, please keep me posted on your progress. The doctors think I'm crazy, but I have the same thing you described. I have terrible mornings, with as many as 15 bowel movements between waking and about 2 PM. Around 2 PM, I'm fine for the rest of the day, other than the aching and pain in and around my bottom. I've lost over 15 pounds. My PPH surgery was September 17, so it's been about 3 and a half months now. My surgeon has since said that if he knew I had IBS, he would not have done the surgery. I think the spasms are the worst part. But, then the spasms cause the bowel movements, and the bowel movements cause the pain. So, I am actually in worse shape now than before my PPH surgery. The surgeon performed an outpatient procedure on 12/22 to double check what was going on. He found that one of the staples from the PPH was lodged somewhere it should not have been and he removed it. He also did a colonoscopy to check for any chronic diseases, but everything was fine. My surgeon believes the next step is the traditional hemorroidectomy, but cannot perform the surgery until the IBS is under control. So, three and a half months later, I'm still in a lot of pain from the hemorrhoids that the PPH surgery was supposed to correct.

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