Frequently Asked Questions in proctology

Outpatient surgery means that you come in for surgery and go home again on the same day. You spend the nights at home in a safe environment. However, there is one prerequisite: you must be picked up by a trusted person after the operation, and someone must be with you for the first 24 hours after the operation to be able to get help if any problems arise. On the day of the operation, you will arrive at our practice in Berlin-Lankwitz 30 minutes before the operation and can leave again 1 hour after the operation, accompanied by someone.

The blood thinner ASA (acetylsalicylic acid), also known as Aspirin®, should be discontinued 8 days prior to surgery if possible. For some patients, this is not possible (heart attack, heart stent, stroke), so surgery can be performed even with ASA, but with a slightly increased risk of bruising after the operation. We do not perform outpatient surgery for other blood thinners.

Botox is a neurotoxin that is increasingly being used in medicine to treat muscle tension. In the case of anal fissures, it relaxes the internal sphincter muscle, thereby improving blood circulation. This leads to faster and often more effective wound healing. After about 5-6 months, the effect wears off and does not need to be repeated as the wound has already healed.

Sie kommen am Operationstag bitte nüchtern in das Krankenhaus bzw. in unsere Praxis. Blutverdünnende Medikamente müssen vorher je nach Wirkstoff 1-3 Tage pausiert sein. Tragen Sie bei ambulanten Eingriffen bequeme Kleidung und denken Sie an eine Begleitperson, die Sie aus der Praxis abholt.

You can take a full bath from the second day after surgery. Open wounds on the anus or coccyx should be rinsed twice a day with clean tap water for 10 days. There is no risk of infection. Then apply a dry dressing. For hygiene reasons, you should wait four weeks before visiting a public sauna.

Depending on the type of surgery, anal surgery can be very painful. You should always expect to be out of work for 5-10 days. We will be happy to issue you with a certificate of incapacity for work on the day of the surgery. You can then obtain any extensions from us or your family doctor.

After surgery involving open wounds, no sporting activities should be undertaken for the first 2 weeks, as this can lead to injury to the wound with subsequent bleeding and wound healing disorders. This applies in particular to cycling and rowing. After pilonidal sinus surgery, no sporting activities should be undertaken for 4 weeks. However, you can sit and walk immediately after the operation.

Before surgery under general anesthesia, you must fast for 6 hours, which means no food, no smoking, and no coffee with milk, for example. For outpatient surgery, you may drink still water or tea without milk up to 2 hours before anesthesia. After surgery, you should eat light meals on the day of surgery and avoid foods that cause flatulence, such as beans or lentils, for the next few days.

The less you smoke before surgery, the better the wound healing will be. You must not smoke for 6 hours before undergoing general anesthesia. Every day that you do not smoke after surgery promotes microcirculation in the wound and thus wound healing. Please keep this in mind.

Unfortunately, pain is also part of surgery, but there are differences. To minimize pain, you will be given medication during the operation and all patients receive local infiltration analgesia to keep you as pain-free as possible. Please be sure to take the pain medication administered during the first 3 days. Often, more severe pain only occurs after 2 days. Overall, pain often lasts for 7-10 days, after which there is usually a significant improvement.

You can go swimming with open wounds without any problems. This does not interfere with wound healing, but salt water can cause a burning sensation. For hygienic reasons, you should only use public swimming pools or saunas once the wound has healed completely.

Wounds in the anal area are very sensitive in the first few days and bleeding and pain may occur. We recommend that you refrain from sporting activities for the first 14 days. After that, you should avoid sports that put strain on the buttocks, such as cycling, horse riding, or rowing, for a further 2 weeks. Running, weight training, or swimming can be resumed without any problems after 2 weeks.

Do not be concerned about your first bowel movement. Your stool should be soft. If you experience problems on the first day after the operation, be sure to take a mild laxative. You may wish to eat only light meals on the day before the operation. After a bowel movement, rinse the wound with tap water for 2 minutes. Refrain from sports that put strain on the buttocks, such as cycling, horse riding, or rowing, for 2 weeks. Running, weight training, or swimming can be resumed without any problems after 2 weeks.

All patients who undergo surgery under anesthesia at our clinic receive a follow-up appointment on the first day and approximately 3-5 days after the operation. If there are no serious complications, the next follow-up appointment is scheduled for 6-8 weeks later. In the first 2 weeks after surgery, patients with acute symptoms can come in without an appointment during office hours. There may be a short wait time. Please be sure to inquire in advance by email (info@copv.berlin). If you have any organizational questions regarding scheduling or rescheduling appointments for surgery, please send us an email at op@copv.berlin.

Most anal surgeries result in an open wound, which usually heals without any problems. However, this can vary considerably depending on the size of the wound. You should expect it to take 4-8 weeks. The wound will release some fluid, which is often yellowish and slimy. This is fibrin, a natural wound adhesive produced by the body, which should not be confused with pus and is part of the open wound healing process. It is important to be patient and wait.

In principle, all open wounds in the anal area should be rinsed twice a day for 1-2 weeks and after each bowel movement for 2 minutes with clear tap water without additives. This reduces the number of germs. Afterwards, only a compress needs to be applied, if necessary with a little wound ointment such as panthenol. Disinfection is not necessary.