Concerns Regarding Anal Dilation After Skin Tag Excision: Potential Impact on Sphincter Strength?
I’m a 20-year-old female residing in the UAE. Five months back, I underwent a surgical procedure to excise two small anal skin tags, which were previously identified as hemorrhoids. The plan established with my parents was solely for excision without any other interventions. However, upon receiving the discharge summary, I was surprised to read that it included a diagnosis of "chronic anal fissure + tag" and mentioned that anal dilation was performed. Prior to the surgery, I never experienced pain typically associated with fissures, and this was not brought up during my consultations. Recently, I sought a second opinion from a colorectal specialist. The manometric evaluation indicated lower resting and contraction pressures in both of my sphincters than what is normally expected. Subjectively, I have also begun to notice an increase in stool residue post bowel movements, and there’s a difference in how everything feels now. I have a few questions that I'm hoping someone can help with: - Is there ever a justification for performing anal dilation when there are no evident symptoms of a fissure? - Could the anal dilation procedure be responsible for the reduced strength in my sphincters? - Is there a possibility that this damage could be reversible, or with time and pelvic floor rehabilitation, can function return to normal? Does this situation suggest any potential malpractice? I appreciate any insights you may have. Thank you!
Answers (1)
9/9/2025, 11:40:50 AM
OpenHealth AI
Thank you for sharing your concerns regarding your experience with anal skin tag excision and subsequent dilation. It sounds like you're facing several uncomfortable changes after a procedure that was not initially explained in full detail. Let’s address your questions one by one, focusing on understanding your situation and providing actionable advice.
Main Points:
- Anal Dilation Justification: Dilation may be performed as part of the treatment for fissures to help relax the anal muscles, but it should be based on clear symptoms or clinical findings.
- Impact on Sphincter Strength: Dilation can potentially weaken the sphincters if not indicated and executed properly, but the precise effect may vary from person to person.
- Reversibility: With time and appropriate rehabilitation, there is a possibility for improvement in sphincter strength and function.
Explanation:
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Anal Dilation Justification: Generally, anal dilation is utilized in cases of anal fissures or sphincter tightness to relieve pain and facilitate healing. However, if you had no symptoms of fissures prior to surgery, performing the dilation could be questioned. Each case should be evaluated based on individual symptoms and clinical findings, ideally discussed before any intervention.
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Sphincter Strength: The decrease in resting and contraction pressures might indicate that the dilation affected your sphincters. This change can lead to issues such as fecal incontinence or increased residue if the sphincters are less effective in maintaining closure post-bowel movement.
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Reversibility: Many patients experience improvement over time with appropriate measures like pelvic floor physical therapy. Strengthening exercises can help restore some function, and giving your body time to heal can also be beneficial.
Next Steps:
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Monitoring Symptoms: Keep a diary of your experiences, noting any changes in bowel movements, sensation, or other related symptoms. This can help track progress and provide valuable information if further evaluation is needed.
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Pelvic Floor Exercises: Research pelvic floor rehabilitation techniques. Working with a specialist in pelvic health can guide you through tailored exercises to strengthen your pelvic muscles and sphincters.
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Communication with Healthcare Providers: If you have not done so, consider discussing your concerns regarding the dilation and the impact on your sphincters with your colorectal specialist. They can provide further evaluations and recommendations for rehabilitation.
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Seek Supportive Care: In the interim, focus on maintaining a healthy diet high in fiber to avoid straining during bowel movements, which can help reduce discomfort.
If you are considering the possibility of malpractice, documenting your case and seeking legal advice might be appropriate after discussing it with a trusted healthcare provider.
Remember, you're not alone in this situation, and there are steps you can take to promote healing and regain confidence in your bowel habits. If you have further questions or need clarification, feel free to ask!
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