About the surgery

You are going to have an abscess removed near the anus. An abscess usually forms due to an acute infection in one of the anal glands, which opens into the centre of the anus. Abscesses are not caused by poor hygiene, sexual activity, toilet habits or diet.

If an abscess is not treated, it will often burst on its own and the pus will drain, but this is usually not enough. Surgery allows us to remove all the infected material and clean the wound. 
The procedure is done under general anaesthesia. 
 
You can expect to go home on the same day as your surgery.

There may be waiting time

We cannot give you an exact time for your surgery, but we will do our best to keep you informed. Because we receive emergency patients around the clock and only have one operating theatre for emergency surgery, the order of procedures may change at short notice. The order is decided by the doctors. Therefore, please be aware that there may be waiting time, and your surgery may be delayed.

Important preparation

You must fast before your surgery

You must not eat or drink before your surgery. This means:

• Stop eating 6 hours before your surgery.
• Stop drinking milk products and juice with pulp 6 hours before your surgery. Do not use milk in your coffee or tea either.
• Stop drinking all types of cold and hot drinks 2 hours before your surgery. We recommend that your last drink should be a large glass of squash (sugary concentrate diluted with water) 2 hours before your surgery. The sugar helps prevent nausea and feeling unwell.

We will help you with the exact timing. If you do not follow the fasting instructions, your surgery will be cancelled.

Please tell us if you have diabetes, as special precautions apply.

Remove nail polish and jewellery

During the surgery, we will place a monitor on one of your fingers to measure the oxygen level in your blood. For this reason, you must remove nail polish and artificial nails before your surgery. You can borrow nail polish remover in the ward. You must also remove your watch, jewellery and piercings. You are welcome to bring your glasses, hearing aid and dental prosthesis to the operating theatre. If you wear contact lenses, you must take them out before the surgery.

Take a shower

We recommend that you take a shower before the surgery. 
You will be given clean hospital clothes before the surgery. You are not allowed to wear your own clothes or underwear.

Brush your teeth

Before the surgery, you must brush your teeth thoroughly. We will give you a toothbrush and toothpaste.

We will give you pain relief and blood-thinning medicine

Shortly before you are taken to surgery, you will be given preventive pain relief medicine. You must take it with as little water as possible. 
To prevent blood clots, we will also give you an injection with blood-thinning medicine in your thigh. You will also be given compression stockings.

The surgery

You will have general anaesthesia

The surgery is done under general anaesthesia. To give you the anaesthetic, we will insert a cannula in your hand. You will receive medicine through the cannula that makes you sleep and feel no pain.

The surgery

Once the anaesthetic has taken effect, the doctor will make an incision in the abscess, drain the pus and clean the wound with a small amount of water. The wound will not be closed with stitches but will heal from the bottom up to prevent the abscess from returning.

After the surgery

Waking up after the surgery

When the surgery is finished, we will take you back to the ward, where you can receive visitors. In some cases, you may need to stay in the recovery unit.

The anaesthetic may cause nausea

You may feel sick or vomit because of the anaesthetic. If needed, we can give you medicine to relieve the nausea.

You may eat and drink after the surgery

We will offer you something to eat and drink when you return to the ward.

We will talk to you about the surgery

After the surgery, we will explain how it went.

Move around after the surgery

You should get out of bed and start moving as soon as possible after the surgery. This will help you recover more quickly and reduce nausea and the risk of complications.

You will be discharged

Most people are ready to be discharged a few hours after the surgery. You are ready if you:

• do not have nausea or significant pain
• have eaten and drunk
• have passed urine without any problems
• have been informed about what to watch out for at home.

At home

The following section tells you what to watch out for when you are back at home.

Discomfort or pain

Continue taking pain relief

You should continue taking pain relief as long as you are in pain. For most people, this is about 3 days. We recommend that you take the medicine at fixed times for 3 days after the surgery:

Do not take ibuprofen if you have chronic bowel disease (Crohn’s disease), have had a stomach ulcer, or if your own doctor advises against it for other reasons.

In some cases, you may need stronger pain relief, which you will receive to take home from the hospital.

Care and hygiene

Rinse the wound every day

Until the wound has healed, it may leak blood and fluid. You must rinse the wound and the surrounding area with lukewarm water morning and evening. Avoid getting soap in the wound. Dry the skin thoroughly afterwards, and if needed, apply a dressing or plaster to protect your clothes. 
We advise against taking baths or going to swimming pools until the wound has healed, as this increases the risk of infection. You are allowed to swim in the sea.

Eat and drink as usual

After the surgery, you may eat and drink as you normally do.

Avoid constipation

If you have not had a bowel movement 2–3 days after the surgery, we recommend that you take 2 tablets of Magnesia before going to bed. Magnesia is available over the counter. Remember to drink plenty of fluids – ideally 1½–2 litres per day – and to stay as active as possible. If you get diarrhoea, you must stop taking Magnesia.

You may want to sit on cushion

If sitting is uncomfortable after the surgery, you can take a cushion home with you.

Help your body recover

After your surgery, movement, diet, smoking and alcohol all play an important role in how quickly you regain your strength and how well your wound heals. 
You can read about how to support your recovery at www.bispebjerghospital.dk/patientguiden (in Danish only). Search for 'livsstil' (lifestyle).

Movement and rest

Return to your daily activities

When you return home, you may resume your usual daily activities and move around as you normally do. Listen to your body and take a break if you feel pain that is not relieved by your pain medicine.

Resume sexual activity when you are ready

You can resume sexual activity when you feel ready and have the energy. It will not harm you, but listen to your body if you feel pain around the wound.

Practical information

Important precautions for the first 24 hours

After having general anaesthesia, there are some precautions you must follow during the first 24 hours. Please note that you:

• must not drive a car or other vehicles 
• must not operate machinery
• should not drink alcohol.

Sick leave

Whether you need sick leave depends on your individual situation. If you do need sick leave for a period, you can get a sick leave notice from your own doctor.

You may need a follow-up appointment

After the surgery, we will assess whether you need a follow-up appointment. If we have not already scheduled an appointment at the hospital, you will receive one via Digital Post or regular post.

When to seek medical attention

Contact us if you notice signs of infection (Open phone contact)

During the first 3 days after the surgery, you can contact Kirurgisk Modtageafsnit KMO (Surgical Admissions Unit (KMO)) directly without calling your own doctor first. We call this open phone contact. Please contact us if you experience:

• redness, warmth, swelling or tenderness around the wound
• increasing pain 
• a temperature above 38°C

If it happens more than 3 days after the surgery, please contact your own doctor or call the emergency helpline 1813 outside your doctor’s opening hours.

Contact your own doctor if the wound has not healed after 4 weeks

If the wound has not healed after 4 weeks and is still leaking blood or fluid, this may be due to a fistula near the anus (anal fistula). An anal fistula can occur following an acute infection in one of the glands between the sphincter muscles in the anus.
If the wound has not healed after 4 weeks, you must see your own doctor and get a new referral for examination at Kirurgisk Ambulatorium (Surgical Outpatient Clinic).