PPH surgery refers to anastomotic suprahemorrhoidal mucosal circumcision. Titanium nail shedding after PPH surgery can be determined by defecation observation, anal fingerprinting, and anoscopy. 1. Observation through defecation: After PPH surgery, the titanium nail of the anastomosis ring may be dislodged through defecation. After defecation, if a small white nail appears, it may be the dislodged nail. 2. Anal finger test: To check whether the titanium nail is dislodged or not, it can be determined by anal finger test. During the examination, the doctor will touch the anus area through the finger to check the shedding of titanium nails. 3. Anoscopy: Anoscopy can effectively clarify the situation of titanium nail shedding after PPH surgery. After PPH surgery, patients should take good care of themselves, avoid intense exercise, and at the same time, ensure local hygiene to avoid infection and inflammation, and should go to the hospital for examination and treatment in time when they feel unwell.