Seeking Guidance on Surgical Recommendations Despite Doubts
At the age of 29, I have been afflicted with severe anal discomfort for the past six months. Initially, without performing a proctoscopic examination or using a finger, two colorectal surgeons concluded that I was experiencing external hemorrhoids and skin tags, despite my descriptions of excruciating pain, which I likened to 'the sensation of passing glass'. I also have a long-standing anal fistula that has persisted for six years. While it had not caused me significant distress previously and I lacked the opportunity for treatment, the surgeons expressed frustration over my delay in seeking care. Consequently, they recommended a colonoscopy. It took months for me to accept the need for this procedure, but I finally went through with it. The colonoscopy itself was manageable, and I emerged without any severe issues. The findings revealed an anal fissure, second-degree hemorrhoids, and my existing fistula, which the physician classified as simple in nature. The report from the procedure did not provide extensive details, merely noting the fissure, fistula, second-degree hemorrhoids, and SRUS (solitary rectal ulcer syndrome). Following the colonoscopy, I received a prescription for my SRUS and was advised to undergo surgery, which includesLaser Lis surgery with sentinel pile excision, a fistulotomy, and a Longo procedure (stapled hemorrhoidopexy or laser-based treatment). I comprehend the necessity for the Lis surgery and the fistulotomy. However, I struggle to understand the recommendation for the Longo procedure since my colonoscopy did not indicate any visible prolapse or internal hemorrhoids. My research shows that Longo is typically indicated for internal hemorrhoids, not external ones. When I posed some questions to my doctor, I felt that I may have annoyed him, as I certainly did not intend to question his expertise or undermine his authority. My concern largely stems from the stapler method involved in the procedure. If you have reached this point and possess insights into colonoscopies and colorectal surgical options, I would greatly appreciate your guidance. Should I seek a second opinion, or should I proceed with trust in my surgeon? He is the fourth specialist I have consulted and is regarded as the leading expert in this area within my country, yet I remain wary because many doctors here prioritize profit. Thank you for any assistance you can provide.
Answers (1)
7/2/2025, 7:01:23 AM
OpenHealth AI
It's completely understandable that you're feeling uncertain about your surgical options, especially given the complexity of your condition. You've endured significant discomfort for six months, and it’s natural to want clarity regarding the recommended treatments. Here's a structured approach to help you navigate this situation.
Main Points
- Understanding your symptoms and current treatment recommendations is crucial.
- Surgery can be beneficial, but it's important that you feel confident and informed about the procedures.
- Seeking a second opinion or further clarification can provide peace of mind.
Explanation
Your colonoscopy findings, including the anal fissure, fistula, and second-degree hemorrhoids, all contribute to the recommendations made by your surgeon. The Longo procedure, while primarily indicated for internal hemorrhoids, may be suggested in cases where there are significant concerns about maintaining rectal health and preventing future issues, particularly in patients with complex conditions like yours.
It’s important to note that while some professionals may prioritize financial incentives, many are genuinely focused on improving patient health. A qualified expert should be willing to answer your questions thoroughly and patiently.
Next Steps
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Clarify Your Concerns: Make a list of specific questions or doubts about the Longo procedure, particularly regarding why it is recommended in your case despite the absence of visible prolapse.
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Communicate Openly: Schedule a follow-up appointment with your surgeon where you can express your need for clarification. It’s perfectly reasonable to ask for more detailed explanations regarding your treatment plan; this can help build your trust in the process.
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Consider a Second Opinion: If you're still feeling uncomfortable after speaking with your surgeon, seeking a second opinion from another colorectal specialist is a good step. Make sure to choose a reputable professional with experience in treating similar conditions.
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Research and Self-Education: Read credible sources on the recommended procedures, including potential benefits and risks. Websites from organizations like the American Society of Colon and Rectal Surgeons (ASCRS) can provide helpful information.
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Prioritize Your Health: If symptoms worsen, or if you experience increased pain or other concerning changes, reach out for medical assistance right away.
Your health and comfort matter most, and being informed will empower you to make the best decisions regarding your treatment. You deserve to feel confident about the steps you’re taking toward relief and recovery.
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