Surgery and recovery

Perianal abscess surgery

We can treat a perianal abscess with surgery to drain the pus and remove the infected tissue. The surgeon then cleans the area.

You can have the surgery under either a:

  • local anaesthetic (when we give you medicine to make the area numb, but you stay awake)
  • general anaesthetic (when we give you medicine to make you sleep and stop you feeling pain)

Usually, you have a general anaesthetic for this type of surgery. The procedure does not take long and is often done as a day case. This means that you can come to hospital, have your surgery and leave on the same day.

Before surgery

You might have come to the emergency department (A&E) because of the abscess or a clinic might have referred you to the hospital.

We might ask you to come to a pre-assessment clinic before your surgery if you are having a general anaesthetic. At this clinic, we:

  • check your health
  • ask you questions about your medical history (your past and present conditions and treatments)
  • talk to you about your surgery in more detail

If you are in hospital, the doctor might do your pre-assessment on the ward.

After surgery

You need a responsible adult to take you home from hospital. They then need to stay with you for at least 24 hours while you recover from a general anaesthetic.

It is important that you rest for the remainder of the day.

If you need to stay in hospital after your surgery, your doctor or nurse will tell you when you can leave hospital. 

Looking after your wound

It is important to keep the area that you had treated clean.

You need to bathe your wound gently in a warm bath every day. This might help with your pain and it is a good time to change your dressings.

Don't

  • do not use soap, or put salt or any perfumed products in the water, until your wound has healed. This can irritate the wound
  • do not worry if you notice blood in the bath water. This is common and reduces in time

Dressing

You have a dressing over the wound after surgery. Your surgeon or nurse explains what dressings you need and how often you should change them.

Stitches

If you have stitches, your surgeon or nurse will tell you if and when they need to be removed.

If the abscess has become a fistula, the surgeon will not remove it. Instead, they clean the area and put in a Seton stitch (a thread through the fistula to keep it open). This allows the abscess to drain fully without damaging the anal sphincter muscles (which help you to control your bowels).

Contact the ward or department where you were treated if:

  • you keep getting bleeding from your wound

You can phone the hospital switchboard on 020 7188 7188 and ask for the ward where you were treated.

Out of hours, contact you GP or nearest emergency department (A&E). 

Side effects after surgery

We give you antibiotics after surgery to prevent infection and help with your pain. Always complete the full course of antibiotics (take the tablets regularly, as instructed, until you have finished them all).

Make sure that you tell the doctor if you are allergic to any antibiotics.

If you have any problems, you can have your follow-up appointment sooner.

Pain

You might have some discomfort after surgery. The pain gets better over the first few days. 

The affected area can be quite painful for the first couple of days. The pain might seem to get worse before you start to feel more comfortable again, but it eases with time.

When you leave the ward or day surgical unit, we might give you painkillers.
 
It is important that you take painkillers regularly to keep you as comfortable as possible. However, if you only have a little pain, you might not need to take them. Always follow the instructions on the packet and never take more than the recommended amount (dose).

Going to the toilet

After this surgery, you should be able to go to the toilet and poo normally.

We might give you medicine called laxatives. They help you to poo more often and keep your poo soft after the surgery. You might not need this medicine. Your surgeon decides what is best for you. 

Contact your GP or go to your nearest A&E if:

  • you feel generally unwell
  • you have a high temperature (fever)

Returning to work and activities

The time that it takes to return to work depends on how you feel and if you have an active job.

Do as much as you can, but avoid any heavy activity such as lifting, exercise or running during the first week or so after surgery.

  • Build up to your usual level of activity gradually.
  • Do not go swimming until your wound has healed.
  • Do not ride a bicycle for 6 to 8 weeks after surgery.
  • You can have sex as soon as you feel comfortable.

Follow-up appointment

You usually have a follow-up appointment in the hospital about 6 week after your surgery. This is to check your wound, stitches and dressings. We send you the appointment in the post.

If you have not heard about your follow-up appointment 2 weeks after your surgery, please phone the GI surgical access centre on 020 7188 8875 (choose option 3). Ask for an appointment in the Tuesday morning clinic.

Resource number: 0910/VER7
Last reviewed: April 2022
Next review due: March 2024

Contact us

If you have any questions, please contact the GI surgical access centre.

Phone: 020 7188 8875 (choose option 3)

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Contact our Patient Advice and Liaison Service (PALS)

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