Last week, I unfortunately developed a perianal abscess. What I initially thought was a minor issue turned out to be far more serious than expected—something that will likely have a significant impact on the rest of my life. Here’s a brief record of my diagnosis, surgery, and recovery.
July 22 (Day 1: Seeking Medical Help)
At 6 a.m., I realized the severity of the problem for the first time.
For the past two days, I’d felt a lump near my anus that hurt whenever I sat down, forcing me to constantly shift positions. A similar issue had occurred about two months ago during the May Day holiday, when I drove for over 20 hours straight. Back then, I managed with ibuprofen and hemorrhoid suppositories. This time, however, the suppositories didn’t help much. When I touched the lump, I was shocked by its size. A quick online search suggested it might be a perianal cyst or abscess, and surgery seemed inevitable. Thinking it wasn’t a big deal, I immediately booked an appointment at the nearest hospital’s proctology department.
The Consultation
At 8:20 a.m., I arrived at the hospital. Unfortunately, it was pouring rain, and all parking spots were taken. After finally reaching the consultation room, the doctor asked me to undress and lie on the examination table. I couldn’t pinpoint exactly where the pain was because the swelling had spread, making the entire anal area sore. The doctor performed a digital exam and diagnosed it as either a perianal abscess or anal fistula, recommending an ultrasound for further confirmation.
At the ultrasound center, the line was long—I had to wait nearly two hours. Sitting on the metal chairs outside was agonizing; I kept adjusting my posture to endure the pain. While waiting, I searched for videos about perianal abscesses and anal fistulas on TikTok, only to grow more anxious the more I watched.
By 10 a.m., the ultrasound was done, confirming a perianal abscess. By then, I’d learned that the only difference between an abscess and a fistula is whether it has ruptured. If it ruptures, it becomes a fistula; otherwise, it’s an abscess. Thankfully, the ultrasound technician was male—otherwise, I’d have felt extremely awkward, especially since one of the female doctors there was the wife of a former colleague. During the procedure, the technician pressed the probe firmly against my anus, and it suddenly struck me that the same probe had likely been used for prenatal checks earlier. No wonder they disinfect so thoroughly—who knows what that thing touches daily.
With the ultrasound report in hand, the doctor bluntly said surgery was the only option—no alternative treatments. Having watched countless videos about it earlier, I was mentally prepared. I accepted the hospitalization form and headed to the admissions office.
Immediate Hospitalization
Life has a way of throwing curveballs. I’d left home unprepared that morning, driving straight to the hospital. After admission, the nurse informed me I couldn’t leave. Panicked, I called my wife to move the car to our residential parking lot to avoid exorbitant fees.
Once settled in the ward, I felt relatively calm. At noon, the doctor came by and said the surgery would be scheduled for that afternoon. The nurse then listed pre-op tests: X-rays, ECG, another ultrasound, etc. The X-ray and ECG were quick, but the ultrasound had an impossible waitlist. Fortunately, the doctor said skipping it was fine (honestly, the morning ultrasound was sufficient—the afternoon one was just protocol).
My First Surgery
At 3 p.m., the nurse announced the surgery was happening immediately. I frantically called my wife to come.
At 3:30 p.m., I entered the operating room for the first time in my life. Previously, I’d only waited outside as a family member. Now, being wheeled in on a gurney—despite being able to walk—felt surreal. Lying on the operating table, I was hooked up to monitors while waiting for anesthesia.
Then, a hiccup: my admission was routine, but the OR staff thought it was an emergency. Paperwork issues delayed the anesthesia by 30 minutes.
The anesthesia was spinal (unlike the general anesthesia I’d had for a gastroscopy). The anesthesiologist worked on my lower spine for five minutes—intense pressure and pain—before my legs grew numb and warm.
Once fully numb (only faint tingling remained), the surgery began. Two surgeons—a chief and an associate—performed the procedure. I felt nothing but overheard their comments:
The associate sighed several times, muttering, “This is severe.” My heart sank. Later, I learned he was referring to my third-degree hemorrhoids, one of which obstructed the surgical site. They had to remove that external hemorrhoid but left the others untouched.
The surgery lasted about 30 minutes. From the notes dictated to the nurse, I learned it was an “anal fistulotomy with external hemorrhoidectomy,” focusing on the fistulotomy.
Surgical Options
From my TikTok research, I knew perianal abscess surgeries typically involve:
Incision and Drainage (I&D)
- For superficial abscesses (e.g., subcutaneous).
- Pros: Simple, minimal trauma, quick recovery.
- Cons: High recurrence risk; may require follow-up fistula surgery.
Primary Fistulotomy
- For abscesses with a clear internal fistula opening (low-risk cases).
- Pros: Low recurrence, avoids secondary surgery.
- Cons: Requires precise technique to avoid sphincter damage.
Seton Technique
- For complex/high abscesses (e.g., ischiorectal).
- Pros: Preserves anal function, reduces incontinence risk.
- Cons: Slow healing (2–4 weeks), requires multiple adjustments.
Two-Stage Surgery
- First: Drainage to control infection.
- Second: Fistula repair (months later).
- For high-risk cases or unclear internal openings.
The doctors told me they performed a primary fistulotomy—draining the abscess while excising the fistula tract. Recurrence rates were under 10%.
Post-Op Agony
After surgery, numb below the waist, I was lifted onto a gurney and wheeled to my room. Seeing my wife waiting outside, I felt guilty—she’d long warned me about my habits, but I’d ignored her. Now, I’d played myself.
By 5 p.m., I was back in bed, feeling fine… until the anesthesia wore off.
Around 7 p.m., as sensation returned, searing pain radiated from my anus. Regret set in. The doctor’s orders—no movement, no food, no lifting my head for six hours—became torture.
By 8 p.m., the pain was unbearable. Scrolling TikTok distracted me for seconds at a time before agony reclaimed my focus. Counting numbers failed—pain overwhelmed every thought. Time crawled; minutes felt like hours.
At 9:30 p.m., the head nurse allowed me to turn sideways (but not lift my head). Shifting slightly eased the strain on my arms but didn’t dull the pain. Desperate, I questioned the “six-hour” rule’s validity.
By 10 p.m., I was delirious—starving (24 hours without food), desperate to urinate (from IV fluids), and in excruciating pain. Sweating profusely, I begged for painkillers.
At 10:30 p.m., the nurse administered an injection, but relief took 30 minutes—by then, the six-hour mark would’ve passed. The wait shattered me.
At 10:55 p.m., I gave up. With my wife’s help, I hobbled to the toilet but struggled to urinate. Eventually, it came in weak spurts, taking three minutes to finish.
Afterward, I ate congee and a banana, then gulped down pills—especially the ibuprofen, my savior. The painkillers finally kicked in, dulling the agony.
My roommate, a 60-year-old man, had his anesthesia wear off in four hours, leaving him in pain for two. He tossed until 4 a.m., making me dread the night. Thankfully, the drugs worked—I slept intermittently until 8 a.m.
July 23 (Post-Op Day 1)
At 8 a.m., I shuffled around. The pain was still sharp but only 30% as bad as the night before. Breakfast was congee and a banana—I couldn’t finish it. A short walk outside was a struggle, taken step by step.
The morning included IV drips (saline and what smelled like penicillin) and a heat lamp session on my wound—30 minutes of warmth with no discomfort.
At noon, the nurse asked if I’d bought a basin for medicated soaks. My wife was at work, so I ordered one via express delivery. It arrived in 15 minutes (not the estimated hour).
The basin was designed for toilets, but the hospital didn’t have one. Improvising, I placed it on a stool and sat gingerly. The medicated soak burned—now I could distinguish the abscess pain (far worse) from the hemorrhoidectomy pain.
That afternoon, I binged videos on perianal abscesses and fistulas. Most advocated surgery; a few promoted TCM baths, but only one doctor in Fujian championed it.
I relied on ibuprofen all day. Fluid leaked from the wound with every slight fart, requiring constant tissue changes. By nightfall, a 90-sheet pack was nearly gone.
At 8 p.m., my wife brought homemade millet congee and juice. She’s juiced daily for a decade, urging me to join. I’d dismissed it—why juice when you can eat fruit? But she insisted it aided digestion. Scientifically, juicing removes fiber, but her consistency likely ensured steady intake. Over the years, she’s rarely fallen ill, while I’m prone to colds. Maybe I should’ve listened.
July 24 (Post-Op Day 2)
Morning pain was milder. The routine repeated: IV drips and heat lamp.
At 6 p.m., I attempted my first bowel movement. Squatting (no toilet seat) strained the wound, triggering sharp pain. After a quick wipe, I collapsed back into bed.
Ten minutes later, I soaked in medicated water again. Unable to resist, I smoked a cigarette to cope.### July 25 (Third Day After Surgery)
In the morning, I noticed the pain had weakened significantly compared to yesterday. While lying in bed, I barely felt anything, but I could still sense the wound when getting up.
At 8 a.m., the doctor came for rounds and straightforwardly said I could be discharged today. After leaving the hospital, I’d need to return every two days for outpatient wound dressing changes. A nurse came by and told me to continue with medicated soaks.
The morning routine was the same two-step process: IV drip and infrared therapy for the wound. By the time the second IV bottle was nearly empty, I could already feel a distinct pain in the back of my right hand. After finishing the drip, the nurse informed me there were no more IV medications scheduled for the afternoon and removed the cannula. The moment it was taken out, my entire hand felt swollen, with a sharp, throbbing pain. While the needle was still in, I could at least move my hand, but now, after its removal, I couldn’t even muster enough strength to use a lighter. The pain in my hand gradually subsided after about half an hour.
Discharge
At noon, the nurse came to inform me I could be discharged. Just as I was collecting my discharge papers from the nurse’s station, my supervisor texted, saying he’d visit me at 2 p.m. I initially wanted to decline, but since I had earlier told him I’d only be discharged in the afternoon, and he had insisted on visiting me at home, I reluctantly agreed—just to minimize hassle. The main issue was that my wife was away for the weekend, leaving the house in disarray. A hospital visit would be more convenient than hosting at home. Besides, such visits are practically a procedural requirement—whenever an employee or their immediate family is hospitalized, the workplace is obligated to send someone. However, due to recent local efforts to prevent a Chikungunya fever outbreak, nearly all staff had been mobilized for epidemic control, leaving no time until today.
After a short nap in the hospital bed, my supervisor arrived at 2 p.m. Following some polite small talk, I prepared to complete the discharge procedures. Over the past few days, I had received daily invoices at my bedside. I had initially paid a 1,000-yuan deposit but hadn’t made any additional payments. This morning, the outstanding balance showed 8,000 yuan, making me assume I’d have to cover a significant portion out of pocket. To my surprise, when settling the bill at discharge, I only had to pay 340 yuan, with 660 yuan refunded from my deposit. That was completely unexpected.
Returning Home
At 4 p.m., I took a taxi home. Sitting on the sofa for a test run, I still felt some pain. After a shower, I sorted the medications prescribed by the hospital—some for oral use, others for external application. Then, I eagerly headed to the toilet for a bowel movement. To my frustration, nothing came out. Fortunately, the seated toilet was far more comfortable than the hospital’s squat-style one, so the process didn’t add extra pain. After resting in bed for 10 minutes, I tried again—still no luck. Panic started creeping in because I was 100% certain the stool was right there, just unable to pass. I paced around the house for another 10 minutes before attempting a third time. This time, under immense strain, I finally managed to pass the stool—hard and foul-smelling, as expected. Unfortunately, it still didn’t feel complete; I could distinctly sense some remained inside. But by then, I had exhausted all my strength and had to take a break before trying again. Throughout this ordeal, I had already sweat through my clothes twice.
Since I hadn’t experienced constipation in a long time, encountering such difficulty two days in a row made me uneasy. Moving forward, I’ll need to address this issue seriously—at the very least, increasing bowel movements to twice daily to prevent stool hardening and blockage. Additionally, my diet of plain congee and rice porridge over the past few days likely contributed to the problem. A more balanced diet is necessary.
Interim Reflection
The above was recorded on my phone during my hospital stay, mainly for future reference—a reminder to always remain vigilant.
The treatment process isn’t over yet. For the next month after discharge, I’ll need continuous follow-up examinations. At home, I used a mirror to inspect the surgical wound, and the sight was… indescribable. A spoon-sized wound, completely exposed, meaning the coming month will undoubtedly be a prolonged ordeal. As someone on Douyin (TikTok) put it: Hospital treatment accounts for only 30% of recovery; postoperative care makes up the remaining 70%. To heal fully and prevent recurrence, there’s still so much work ahead.
Finally, I hope my experience serves as a cautionary tale for readers. Perianal abscesses strike swiftly and without warning. Once symptoms appear, immediate surgery is a must. Delaying could lead to irreversible consequences.