What this experience covers
This experience describes what happens when pelvic floor dysfunction develops after anal surgery — procedures like lateral internal sphincterotomy (LIS), fissurectomy, haemorrhoidectomy, or fistula repair. It is drawn from many anonymised accounts and represents common patterns, not any single person’s story.
The surgery goes well. The wound heals. But something is not right. The pain is different now — not the sharp, localised pain from before, but something deeper, wider, harder to pin down. For many people, the answer turns out to be pelvic floor dysfunction. Getting to that answer is often the hardest part.
The pattern
The surgery works, but the recovery stalls
People describe a familiar sequence. The first few weeks after surgery are difficult but expected — pain, healing, adjustments to routines. Then things improve. The surgical site heals. Examinations look good.
But somewhere along the way, the recovery plateaus. Pain that was supposed to be fading is not. Or it changes character entirely. Instead of sharp pain at the surgical site, there is a dull ache deeper in the pelvis. Sitting becomes uncomfortable in a different way. There is a constant sense of tightness or pressure.
The pain changes character
People consistently describe the shift:
- The original surgical pain was localised and identifiable. This new pain is diffuse and hard to describe
- It may feel like pressure, heaviness, or a deep ache in the rectum or pelvis
- It worsens with prolonged sitting rather than with bowel movements
- Stress makes it worse. Relaxation makes it better — but relaxing is hard when you are in pain
- It can radiate to the tailbone, hips, sit bones, or inner thighs
This is confusing because the surgery was supposed to fix things. People describe returning to their surgeon expecting bad news, only to be told the surgical site looks fine.
The diagnosis gap
This is where many people get stuck. Examinations show healing. The surgeon is satisfied. But the patient is still in pain every day.
People describe being told variations of “everything looks good” or “give it more time.” Some are told the pain will settle. Some are told nothing is wrong. A few are told it might be psychological. Weeks become months.
The gap between what examinations show and what people feel is the most frustrating part. The pain is real. It is physical. But it is not coming from the surgical site anymore. It is coming from the muscles around it — the pelvic floor — which have been guarding and clenching for months.
Finding the answer
For most people who eventually get answers, the turning point is a referral to a pelvic floor physiotherapist. The assessment reveals what standard post-surgical examinations do not: chronically tight pelvic floor muscles, trigger points, and a body that has not learned to let go of the protective tension it developed during months of pain.
Pelvic floor physiotherapy — involving manual therapy, biofeedback, breathing techniques, and home exercises — helps most people in this situation. Progress is gradual, typically over weeks to months, but people consistently describe it as the thing that finally made the difference.
The emotional weight
Having pelvic floor dysfunction after surgery carries a particular kind of frustration. People describe feeling like the surgery was a mistake, or that something went wrong — when in reality the surgery worked but created a secondary problem that no one warned them about.
The isolation is compounded by the assumption — from doctors, from family, from themselves — that the surgery should have fixed everything. Explaining that you are still in pain after a successful surgery is difficult. People often stop talking about it.
When to contact your doctor
People describe seeking medical input when:
- Pain persists or changes character weeks after surgical healing is confirmed
- They suspect something beyond the surgical site is causing their symptoms
- They want a referral to a pelvic floor physiotherapist
- New symptoms develop that were not present before surgery
Seek prompt medical attention if you experience: significant bleeding that will not stop, fever with pelvic or abdominal pain, sudden severe pain that is different from your usual symptoms, loss of bowel or bladder control, or any new symptoms that concern you. These may indicate something that needs urgent assessment.