Anal stenosis is an uncommon but important complication of anorectal surgery, most frequently occurring after hemorrhoidectomy. While mild cases may be managed conservatively, severe stenosis typically fails to respond to non-surgical interventions and requires operative correction. The diamond flap technique has increasingly been recognized as a valuable option, providing both optimal tissue perfusion and good functional outcomes. We report the case of a 60-year-old man with a history of hemorrhoidectomy performed approximately 20 years earlier who presented with long-standing symptoms of obstructive defecation. After conservative management failed, surgical treatment was undertaken using a diamond-shaped mucocutaneous flap for scar excision, reconstruction of the anal canal, and limited external anal sphincter release. This case report describes a patient with severe anal stenosis developing after hemorrhoidectomy who was successfully treated with diamond flap anoplasty. Diamond flap anoplasty is an effective surgical approach for the management of severe anal stenosis following hemorrhoidectomy. In this patient, the procedure achieved anatomical restoration and adequate widening of the anal canal while preserving sphincter integrity, resulting in a positive outcome. Awareness of anal stenosis as a potential late complication of hemorrhoidectomy is essential, as early recognition facilitates appropriate selection of reconstructive techniques and optimizes functional outcomes.
Dimov et al. (Tue,) studied this question.