Post-Surgery Recovery: Anal Tightness and Discomfort

Postoperative care after anal surgery?

Hello doctor, I am a gay man.
I had surgery for internal hemorrhoids and rectal prolapse.
It's been over two months, and my bowel movements have gradually become firmer and are no longer painful.
The wound has healed, but there is still a small stitch at the surgical site that is slowly getting smaller.
Today, I engaged in sexual activity with my partner, but during the process, my anus felt very tight, and what was initially comfortable became uncomfortable and painful, leading me to give up.
I feel guilty about this towards him.
Will it always be like this, or does it just need more time to heal? How long might that take? I cannot ask my doctor about this because my family knows him, and I haven't come out yet.

A Hong, 20~29 year old female. Ask Date: 2017/03/02

Dr. Ke Fangxu reply Surgery

After hemorrhoid surgery, the wound will fully heal within one to two months.
However, similar to other types of injuries or surgeries, scar tissue will take about six months to be completely absorbed by the body.
I have not researched anal intercourse extensively, but generally, it can be resumed after the wound has healed.
It is uncertain whether it will return to its pre-surgery state; perhaps it will return to normal in two to three months.

Reply Date: 2017/03/02

More Info

Post-surgery recovery, especially after procedures like hemorrhoidectomy and rectal prolapse repair, can be a complex and sensitive topic. It's understandable that you're experiencing discomfort and tightness in the anal area, particularly during sexual activity. Let's break down your concerns and provide some insights into what you might expect during your recovery.

Firstly, it's important to recognize that after surgery, the tissues in the anal region can be sensitive and may take time to heal completely. The tightness and discomfort you're experiencing during sexual activity could be attributed to several factors:
1. Healing Process: After surgery, the body goes through a healing phase where tissues repair themselves. This can involve inflammation and sensitivity, which may cause tightness. The presence of a stitch or suture can also contribute to discomfort, as it may irritate the surrounding tissues.

2. Muscle Tension: The anal sphincter muscles may be tense or hypertonic post-surgery. This tension can lead to discomfort during penetration. It's not uncommon for individuals to experience changes in muscle tone and control after such surgeries, which can affect sexual experiences.

3. Psychological Factors: Anxiety or apprehension about pain during sexual activity can lead to increased muscle tension. If you're worried about discomfort, this can create a cycle where the anticipation of pain leads to actual discomfort.

4. Time for Recovery: Generally, the recovery period can vary from person to person. While some individuals may start to feel more comfortable within a few weeks, others may take several months to fully recover. It's essential to listen to your body and give yourself the time needed to heal.

Regarding your specific question about whether this tightness and discomfort will persist, it's likely that as your body continues to heal, you may notice improvements. However, it’s crucial to communicate openly with your partner about your feelings and experiences. This can help alleviate any guilt you may feel and foster understanding between you both.

Here are some recommendations to help with your recovery:
- Gentle Stretching and Relaxation: Consider incorporating gentle stretching exercises or relaxation techniques to help ease muscle tension in the anal area. This can include pelvic floor exercises, which may help improve muscle control and relaxation.

- Warm Baths: Soaking in warm baths can provide relief and promote relaxation of the anal sphincter muscles. This can be particularly soothing after bowel movements or before engaging in sexual activity.

- Lubrication: If you decide to engage in sexual activity, using a good quality lubricant can help reduce friction and discomfort. This is especially important if you are still experiencing tightness.

- Follow-Up with a Healthcare Provider: If the tightness and discomfort persist or worsen, it may be beneficial to consult with a healthcare provider who specializes in pelvic health or sexual medicine. They can provide tailored advice and may suggest physical therapy or other interventions to aid in your recovery.

In summary, while it's normal to experience some tightness and discomfort after surgery, these symptoms should gradually improve as you heal. Be patient with yourself and consider seeking professional guidance if you have ongoing concerns. Your recovery is a process, and it's essential to prioritize your comfort and well-being during this time.

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