
Hi, I Ve Had Some Recent Issues With Abdomen Discomfort,

Its a prolapsed Hemorrhoid.
Detailed Answer:
Hello and Thank you for choosing "Ask a Doctor" service for your query,
Have seen your details and i appreciate your concerns.
Its a Hemorrhoid(Prolapsed) and need immediate attention.
As is it prolapsed Hemorrhoidectomy surgery would be done.Surgical hemorrhoidectomy is the most effective treatment for prolapsed hemorrhoids(But only when semen culture become negative post antibiotics).
Suggestion till culture is negative(As no.surgery would be done in active infection)-
Start using a laxative like Miralax to keep stools soft.
Eat fibre supplement daily(30-40gram total fibers).
Consult a Surgeon/Colorectal surgeon in person.
Avoid touching it.
Are you having Rectal heaviness?
Anorectal pain?etc
Follow ups with answer please.


Thank you!
How does this relate to semen culture?
Is thr surgery painful?
Yes, I am having anorectal pain after passing stool and occasionally blood. I do have a current chronic appendicitis as well but not taking it out until I figure out the rectal issues.


Follow up.
Detailed Answer:
Hello again,
Nerve supply of penis,prostate and rectum is through branch of same nerve(pudendal)..Secondly prostate lies just in front of Rectum and venous plexus(blood supply) connects rectum to prostate...Lastly any operation would not be done in presence of active Bacteria in body as this could lead to mortal conditions like Sepsis/Septicemia.
As culture is still positive even after taking Antibiotic for a month...Adding Fosfomycin 3gram once daily for 10 days followed by once every 48 hour should be considered as this is the only antibiotic which shows activity on Bacterial biofilms(which don't allow antibiotics to reach bacteria).
Anorectal heaviness could be due to chronic bacterial prostatitis also.
I would suggest you to follow conservative management of Hemorrhoids as of now and first get rid of prostatitis(a really difficult infection to treat).
Use ointment Prepration H locally over Hemorrhoid and take Laxative with fibers till 2 cultures 15 days apart are negative.
Thank you!

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