Anal Rectal Surgery
Mater Private Hospital Redland was established in September 2000 as an extension of the mission of the Sisters of Mercy to provide the highest quality healthcare services for the people of the Bayside region.
With a growing community in the Bayside districts, Mater Private Hospital Redland offers patients exceptional care close to their families and friends.
Collocated with the Redland Public Hospital, Mater Private Hospital Redland features a 60-bed, three-level main hospital building incorporating patient wards, operating theatres, day procedure unit, chapel, theatres, reception area and utility rooms. It is combined with a single-level building housing a specialist medical centre, radiology and pathology services.
In the spirit of the Sisters of Mercy, Mater Health Services offers compassionate service to the sick and needy, promotes an holistic approach to health care in response to changing community needs and fosters highs standards in health related education and research.
Following the example of Christ the healer, we commit ourselves to offering these services to all without discrimination.
Mercy: the spirit of responding to one another
Dignity: the spirit of humanity, respecting the worth of each person
Care: the spirit of compassion
Commitment: the spirit of integrity
Quality: the spirit of professionalism
At MPHR, we understand that having an operation can be a very stressful experience.
This brochure aims to alleviate some of your concerns, in keeping with our Mission to offer compassionate, quality care that promotes dignity whilst responding to patients' needs, this booklet aims to alleviate some of your concerns. It explains the general day to day events that may occur during your visit and the things to expect following your discharge.
Each person may require different treatments. This brochure is intended as a guide only.
If you have any questions about your treatment please ask your Doctor or Nurse. Our pastoral care team offers a caring support network to all patients. The dedicated members of this team may visit you during your stay and are available at your request to discuss any anxieties or problems that you may have.
Anal/Rectal Surgery is a broad term covering a large number of different conditions of the anal / rectal region requiring surgery as the form of treatment. Below are listed common surgeries of this region
Haemorrhoidectomy: When haemorrhoids are extensive, prolapsing or incarcerated, they may require removal by surgery. This is done under anaesthesia. Because there is a risk of causing permanent damage to the sphincter (the muscle that controls your bowel movement), this operation is only done if absolutely necessary. A small amount of skin, inner lining of the anus and the piles tissue which consists of the abnormally swollen blood vessels are removed.
Drainage of abscess: A perirectal abscess is a collection of pus in the deep tissues surrounding the anus. By contrast, a perianal abscess is a shallower collection of pus under the skin surrounding the anus. Both types of abscesses need immediate attention to prevent the condition worsening or resulting in unnecessary complications. For drainage of abscess, the skin is cut open. The wound is not stitched back together allowing any discharge left inside to drain out.
Fissures / Fistula: An anal fissure is a tear in the skin inside the anal canal. When this skin is torn, you may have pain with each bowel movement and pass bright red blood. An infection of the gland inside the anus can cause it to fill with pus. This is an abscess. After the abscess is drained, there may be a tunnel from the anus to the skin. This is a fistula. A fistula can cause pain, fever and drainage.
Sphincterotomy surgery allows a fissure or fistula to heal. A small part of the anal sphincter muscle is cut to open the anal canal. This relieves pressure when you move your bowels and allows a fissure to heal.
Polpypectomy is a procedure to locate and remove polyps from the bowel using a colonoscope. Polyps are small growths on the bowel lining that are most often benign, but can sometimes contain a small area of cancer. Polyps also have the potential to develop into bowel cancer at a later stage.
Polyps are removed using a specially designed wire that is passed down the colonoscope (avoiding the necessity for a major operation). The wire has a loop at the end that can be snared around the 'stem' of a polyp and charged with a painless electric current that cuts the polyp away from the bowel wall. The early removal of polyps stops them from becoming malignant, making it a key way to protect people from bowel cancer.
EXPECTED LENGTH OF HOSPITAL STAY: 1 – 2 days
DATE OF ADMISSION: .........................................................................................................
PLANNED DISCHARGE DATE: .............................................................................................
ACTUAL DISCHARGE DATE: ................................................................................................
Prior to discharge:
- You will be independently mobile, attending to your daily needs.
- You will be educated on sitz baths.
- You will be educated on maintaining pain control.
- You will be educated on the importance of a well balanced, high fibre diet.
- Your temperature, pulse and blood pressure are to be within normal limits.
- No unexpected discharge or bleeding from your wound.
MPHR provides a pre-admission health assessment on the information you have provided to us. You may receive a phone call if required to clarify any health information you have provided.
This pre-admission service gathers information, initiates investigations to prepare you for your surgery, provides information regarding your specific operation and identifies discharge needs.
Things to do before you come to hospital:
- It is important for you to have completed all the tests which your doctor has ordered prior to coming to hospital. Please bring any X-rays, any ECG reports and all your blood test results with you to hospital along with your medications. Your medications need to be in their labelled containers or Webster pack.
- If you are taking any blood thinning or arthritis medications please follow instructions provided by your pre-admission nurse or pharmacist, as sometimes it is important that these medications be stopped in preparation for your surgery.
- It is necessary that you have nothing to eat or drink (including water, lollies and chewing gum) at least six hours before your operation. Please follow instructions provided by your doctor or pre-admission nurse.
- It is important for you to shower and dress into clean clothes prior to coming into hospital. No skin products, such as deodorant, perfume, body lotion or powders are to be used following your shower.
- Mater Private Hospital Redland is unable to accept liability for losses. It is highly recommended that you leave your valuables at home for safety and security purposes. Please bring essential items only. While Mater does not take responsibility for your personal belongings our security office will hold any lost property that is handed in.
- Read this brochure and print it, ready to bring with you to hospital.
The day of your operation
Before your operation
- When you come to hospital proceed to Reception at Mater Private Hospital Redland foyer. You will be directed to where you will be admitted.
- The assessment form completed at the pre-admission service will be reviewed and your health team will plan for your individualised care while in hospital and any support you may require after discharge. Your nurse will also check that your consent form has been signed or organised to be signed before your operation.
- Your nurse will discuss any concerns that you may have about your surgery and needs that you may have when you are discharged.
- It is an infection control requirement at Mater that you will be required to have swabs taken if you have transferred from or worked at another health care facility or you have had previous resistant infections. This is usually identified and attended at the pre-admission clinic. Your admission nurse will check if these three swabs have been taken and will complete the test if there are further swabs required.
- The medications you brought to hospital will be collected. These will be returned to you when you leave the hospital. Please inform the nurse admitting you if you have been taking any blood thinning or arthritis medications prior to your admission, as these may have needed to be stopped before your operation day. It is usual for you to continue taking your other prescribed medications.
- You may walk as much as you like. Please notify staff if you leave the ward.
- You will have an identification armband applied. This will stay on for the duration of your stay for identification and safety reasons. For your safety and if you have known allergies, you will have a red allergy armband applied.
- Your nurse will take a set of baseline observations (temperature, pulse, blood pressure), weigh you and may ask you to provide a urine sample for routine testing.
- In preparation for your surgery you will need to have a microlax which will stimulate your bowel to open.
- You will be asked to dress into theatre clothing.
- You will be measured for special stockings (TEDS) and will need to have one stocking put on your un-operated leg prior to going to theatre. This assists with blood flow through the blood vessels of your leg and decreases the risk of blood clot formation while you have decreased mobility.
- You may be prescribed a medication before you go to surgery.
- Before you leave for theatre a pre-operative check list will be completed with you by your nurse. This check-list will be repeated in the operating reception area. Apart from your wedding band, no jewellery or metal is to be worn to theatre.
- You will be escorted to the operating suite.
- It is important to practise your breathing and leg exercises which you will need to commence once you have woken up from your operation.
Breathing and circulation exercises
The following exercises help prevent complications such as chest infections and blood clots in your legs. You should do these every hour that you are awake while resting in bed.
Breathing exercises: take five long and slow deep breaths. Each breath should be deeper than the previous breath. Think about getting the air to the very bottom of your lungs.
Circulation exercises: firmly move your ankles up and down to stretch and contract your calf muscles.
After your operation
- You will stay in the recovery room within the theatre suite after the operation while you waken from the anaesthetic. You will then be transferred in your bed to your room.
- Your nurse will take frequent observations of your vital signs (e.g. pulse) and observe for bleeding or excessive swallowing.
- Immediately following your surgery, you will be resting in bed with your head elevated. When you feel well enough you will be assisted to get out of bed.
- About four hours after you return to the ward, your nurse will assist you to have a wash.
- Immediately post op you may have small amounts of water or ice to suck and then progress to a high fibre diet as tolerated.
- Pain medication will be prescribed and needs to be taken as directed.
- The drip (IV) is necessary to maintain your fluid intake. This will be removed when you are tolerating adequate amounts of oral fluids.
- You may have difficulty passing urine due to the discomfort of your surgery. Please notify your nurse if this is the case.
In preparation of going home
- Your nurse will discuss your follow-up appointment and any discharge arrangements that have been made with you.
- Discharge information will be given to you and your nurse will discuss this with you. If you have any questions, please do not hesitate to ask.
- It is still recommended to perform deep breathing, coughing and leg exercises while you are resting in bed.
- You will recommence your normal medications. Please take your pain medication as prescribed. While on pain medicine, you need to take a stool softener (e.g. Durolax) and a bulk fiber laxative such as Metamucil® to prevent constipation.
- Take a sitz bath at least 3-4 times a day and after each bowel movement. This will help decrease the pain of rectal spasms and aid healing. Sit in a bathtub of warm salt water for 10-20 minutes.
- Your observations (temperature and pulse) will be checked before you are discharged along with assessing any wound bleeding.
Discharge advice following anal / rectal surgery
- Pain medication prescribed needs to be taken as directed.
- Take a sitz bath at least 3-4 times a day and after each bowel movement. This will help keep the area clean, decrease the pain of rectal spasms and aid healing. Sit in a bathtub of warm water for 10-20 minutes.
- A small amount of bleeding or discharge is normal for a few weeks after surgery. It is recommended you use mini-pads or sanitary pads for your underclothing during this time. The discharge will decrease in amount and become lighter in colour. With bowel movements and increased activity you may notice an increase of bloody drainage.
- Eat a well balanced, high fibre diet each day:
- 8 – 10 glasses of non-caffeinated fluid.
- At leas 4 servings of fruits and vegetables.
- At least 4 servings of bread and cereals (2 of these should be whole grain).
- Avoid Aspirin and non-steroidal pain medications (like Ibuprofen) for 10 days.
- Avoid lifting heavy objects as this will put extra strain on your wound area and increase the changes of bleeding, however, it is important to keep active.
- Avoid sitting or standing for longer than 1 hour at a time.
Please contact your General Practitioner (GP) or your nearest emergency department IMMEDIATELY if you experience any of the following after your procedure:
- Large amounts of bright red blood from the rectum that does not stop with pressure to the rectum for 10 minutes.
- A fever.
- Foul-smelling drainage.
- Breaking open of suture line.
- Excessive swelling in the rectal area.
- Unable to control bowel movements.
- Trouble passing urine.
Staff of Mater Private Hospital - Redland
Carepath Coordinator MPHR
Reference: Milliman CareGuidelines: Inpatient and Surgical Care / Ambulatory Surgery 1990 - 2010
Mater acknowledges consumer consultation in the development of this patient information.
Mater Doc Num: HOSP-006-02171
Last modified 13/11/2015.