Is anoplasty superior to scar revision surgery for post-hemorrhoidectomy anal stenosis? Six years of experience

Table 1 Demographic characteristics of patients who underwent surgery for hemorrhoidectomy-associated anal stenosis

	Scar revision surgery	Double diamond-shaped flap anoplasty	P value	Total
Patient numbers	21 (35%)	39 (65%)		60
Age (yr)	54 ± 14.5	55 ± 11.8	0.773	54.65 ±12.65
Sex (male/female)	13/8 (61.9%/38.09%)	23/16 (58.97%/41.03%)	0.825	36/24 (60%/40%)
Preoperative severity of anal stenosis			< 0.001
Mild	17 (80.95%)	12 (30.77%)		29 (48.33%)
Moderate	4 (19.05%)	16 (41.03%)		20 (33.33%)
Severe	0	11 (28.21%)		11 (18.33%)
Preoperative symptoms
Strained defecation	21 (100%)	39 (100%)	-	60 (100%)
Incomplete evacuation	13 (61.9%)	26 (66.67%)	0.712	39 (65%)
Painful evacuation	4 (19.04%)	25 (64.1%)	0.001	29 (48.33%)
Defecation bleeding	0	8 (20.51%)	0.026	8 (13.33%)
Incontinence	0	7 (17.95%)	0.039	7 (11.67%)
Adjuvant therapy
Laxative medication	21 (100%)	39 (100%)	-	60 (100%)
Pain control medication	4 (19.05%)	25 (64.1%)	0.001	29 (48.33%)
Digital dilatation	7 (33.33%)	17 (43.59%)	0.439	24 (40%)

Table 2 Surgical outcomes of patients treated surgically for anal stenosis

Patient numbers	21 (35%)	39 (65%)		60
Operative time (min)	10.14 ± 2.31	21.62 ± 4.68	< 0.001	17.6 ± 6.8
Length of hospital stay (d)	2.1 ± 0.3	2.9 ± 0.4	< 0.001	2.62 ± 0.52
Complications
Acute urinary retention	0	4 (10.3%)	-	4 (6.7%)
Wound dehiscence	0	0	0.129	0
Wound infection	0	0		0
Postoperative fever	0	0		0
Postoperative bleeding	0	0		0

Table 3 Postoperative 6-mo follow-up

	Scar revision surgery	Double-diamond-shaped flap anoplasty	P value	Total
Patient numbers	21 (35%)	39 (65%)		60
Postoperative symptoms			-
Strained defecation	2 (9.52%)	0	0.05	2 (3.33%)
Incomplete evacuation	1 (4.76%)	0	0.169	1 (1.67%)
Painful evacuation	0	0		0
Defecation bleeding	0	0		0
Incontinence	0	0		0
Adjuvant therapy
Laxative medication	2 (9.52%)	0	-	2
Pain control medication	0	0	0.05	0
Digital dilatation	0	0		0
Recurrence	2 (9.52%)	0	0.05	2 (3.33%)
Quality of life			0.035
Poor (1–2)	0	0		0
Same (3–5)	2 (9.52%)	0		2 (3.33%)
Good (6–7)	6 (28.57%)	7 (17.95%)		13 (21.67%)
Excellent (8–10)	13 (61.90%)	32 (82.05%)		45 (75%)