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DISCHARGE INSTRUCTIONS AFTER REMOVAL OF CONDYLOMA

PAUL E. SAVOCA, MD, FACS, FASCRS

Anal warts, also known as condyloma, are growths found on the skin around the anus (rectal opening) and sometimes in the anal canal.

Anal warts are caused by the human papilloma virus, which is usually transmitted through sexual contact but not necessarily through anal intercourse. The same type of warts may occur on the penis, scrotum, vagina or labia. The time from exposure to the virus and growth of the warts is commonly from one to six months, but it can be longer. During that time the virus remains in the tissues but is inactive. There are many types of human papilloma virus; some cause warts on the hands and feet and others cause genital and anal warts.
When the warts are just on the outer skin they may be able to be treated with a variety of medications applied in the office or at home. However, once the warts extend into the anal canal they need to be removed surgically. In most cases, a single treatment will not cure anal warts. Close follow-up is critical because the virus may continue to be present and cause new anal warts to form. Even after there are no visible warts, the virus may remain in the tissue. Small warts that reappear are easily treated in the office. Follow-up visits are necessary even after there are no visible warts. Visits may be necessary for up to six months. There is a possibility of serious problems if the warts are left untreated. On rare occasions, these warts can become cancerous, so it is important to keep the follow-up appointments the doctor suggests.

During the operation you have undergone the warts have been removed and the underlying surface has been burned slightly to eradicate the virus in the area.

Home Care

  • A small amount of bleeding is common following rectal surgery. A sanitary napkin or gauze may be worn over the anal opening to keep the underclothing clean. If there is prolonged or profuse bleeding with passage of clots, call the office at once.
  • You will be given a prescription for pain medication. Follow the directions given by your doctor for taking this medication. To avoid upset stomach, take your pain medication as prescribed with food in your stomach.

Take these drugs exactly as directed. Never take more than the recommended dose, and do not take the drugs more often than directed. If the drugs do not seem to be working, call the office for advice. Do not share these or any other prescription drugs with others because the drug may have a completely different effect on the person for whom it was not prescribed.

Some people experience drowsiness, dizziness, lightheadedness, or a false sense of well-being after taking opioid analgesics. Anyone who takes these drugs should not drive, use machines, or do anything else that might be dangerous until they know how the drug affects them. Nausea and vomiting are common side effects, especially when first beginning to take the medicine. If these symptoms do not go away after the first few doses, check with the physician who prescribed the medicine. Side effects may include: dizziness, lightheadedness, nausea, sedation, vomiting, if these side effects occur, it may help if you lie down after taking the medication.

  • If you were given a topical ointment place a thin layer over the anal wounds after baths and bowel movements.
  • Avoid strenuous activity for 1-2 weeks after your procedure.
  • Ask someone to drive you to appointments until you are able to sit and move comfortably.
  • Take sitz baths (sit for 15-20 minutes in warm water) at least 3 times a day and after each bowel movement.
  • Don’t worry if you have some bleeding, discharge, or itching during your recovery. This is normal.
  • Avoid constipation.
    • Take Benefiber or other psyllium product (Metamucil, Citrucel, Konsyl, etc) one teaspoon twice a day. Take a stool softener such as Colace or Surfak twice a day as well.
    • If you have not had a bowel movement by the morning of the fourth day following surgery, take 2 fleet enemas, 1 hour apart (lubricate the tip of the enema well with Vaseline and insert gently). If no result, drink one bottle of citrate of magnesium, which can be purchased at any pharmacy. Following the first bowel movement, you should have a bowel movement at least every other day. If 2 days pass without a bowel movement, take an ounce of milk of magnesia. Repeat in 6 hours if no result.
    • The use of dry toilet tissue should be avoided. After bowel movements use a wet Kleenex, cotton or Tuck’s pads to clean yourself, or if possible, take a warm bath.
  • Eat a regular diet including plenty of fresh fruit and vegetables. Drink 6-8 glasses of water a day.
  • Call the office if your temperature is greater than 101 degrees.