Anal stenosis occurs when the normally flexible anoderm is replaced by fibrotic connective tissue leading to an inelastic and abnormally tight anal canal. Most anal stenosis cases are secondary to surgical trauma related to hemorrhoidectomy. Pain with defecation is the most frequent complaint of patients, followed by difficulty in expelling stool and gas, and bleeding at the time of evacuation.We show the video of a 40-year-old female patient with a history of a period of 15-days, she had two emergency hemorrhoidectomy surgeries performed in a rural hospital due to a severe hemorrhoidal crisis.Due to a painful postoperative evolution, the patient decides to go to the office with colorectal surgery two weeks after her last surgery due to intense pain with difficulty to evacuate. The physical examination demonstrates an anal stenosis with a scar after hemorrhoidectomy that has not yet healed.Conservative outpatient treatment is offered until an additional 6-weeks are completed until the wound from the last surgery has healed completely. After this, an anal review under general anesthesia is performed. A moderate, circumferential and distal anal stenosis is observed. A diamond-shaped flap anoplasty is performed.
In the postoperative period, the patient receives a diet low in residues, antibiotics and surgical care of the wound with heat (hair dryer) to minimize moisture in the surgical area and ensure adequate healing. The patient progresses well and is discharged at two- weeks postoperative.In the second-month postoperative with total wound healing, achieving a feeling of complete evacuation, without pain and stool Bristol-4.