A 52-year-old male patient underwent a haemorrhoidectomy for severe hemorrhoids. On the first postoperative day, he reports difficulty in urinating and increasing lower abdominal discomfort. On examination, his bladder is distended.
The most common early complication following haemorrhoidectomy in males is:
A. Urinary retention
B. Fecal incontinence
C. Anal stricture
D. None
The Correct Answer is: A. Urinary retention
Explanation:
Urinary retention:
Urinary retention is the most common early complication following haemorrhoidectomy, particularly in males. This occurs due to pain and reflex spasm of the pelvic floor muscles, which can interfere with the normal functioning of the bladder. Postoperative urinary retention can lead to bladder distension and discomfort, requiring catheterization for relief. The risk is increased by the use of anesthesia, opioids for pain management, and the surgical manipulation in the anorectal area.
Explanation of Incorrect Options:
B. Fecal incontinence:
Fecal incontinence is a less common complication of haemorrhoidectomy and typically occurs later, if at all. It is more likely associated with damage to the sphincter muscles, but with modern surgical techniques, this risk is minimized.
C. Anal stricture:
Anal stricture is a late complication rather than an early one. It results from scarring and fibrosis during the healing process, leading to narrowing of the anal canal. It typically manifests weeks to months after surgery, not immediately postoperatively.
D. None:
Choosing “None” is incorrect because urinary retention is a well-documented and common early complication after haemorrhoidectomy in males.
Given these considerations, urinary retention (Option A) is the most common early complication following haemorrhoidectomy in males, often requiring prompt management to relieve symptoms and prevent further complications.