Post-Surgery Concerns: Managing Anal Tightness and Sexual Health Issues

Post-operative sexual concerns after anal warts surgery?

Hello, doctor.
It has been over a year since my last three electrocautery surgeries, and there has been no recurrence of lesions.
Based on my research, I should be considered healed, but I am still experiencing some issues.

1.
Since the electrocautery surgery, I have been dealing with constipation.
Previously, my bowel movements were smooth, but now I feel a tightness in the anal area, and my stools are quite thin.
Is this a postoperative complication? I have been soaking in warm water after the surgery, but it doesn't seem to help much.
Are there any other methods to help relax the internal anal muscles?
2.
I am a member of the LGBTQ+ community, and I am currently unable to engage in sexual activity.
I feel like there is a barrier I cannot overcome.
Is it possible that there are still growths inside? I cannot feel anything with my entire index finger inserted.
Can warts grow deep inside?
I would appreciate your help in addressing these two issues.
Thank you.

Du Jue, 20~29 year old female. Ask Date: 2018/10/09

Dr. Ke Fangxu reply Surgery

1.
The issue of constipation should not be related to electrocautery unless the area treated was excessively large, causing anal stenosis; otherwise, such sequelae are unlikely.
It is recommended that you consult your surgeon to check for any actual narrowing, although it is mostly likely just an abnormal sensation.

2.
If the entire index finger can be inserted without palpating anything, it is impossible for there to be a deeper lesion that has not been detected, as condylomas (warts) only grow on the squamous epithelium at the anal opening and do not develop on the intestinal mucosa.

Reply Date: 2018/10/09

More Info

Post-surgery concerns, especially after procedures like electrosurgery for anal conditions, can be quite complex and multifaceted. It’s important to address both the physical and psychological aspects of recovery. Here’s a detailed response to your questions regarding anal tightness and sexual health issues.

1. Anal Tightness and Constipation: It is not uncommon for patients to experience changes in bowel habits and anal tightness following anal surgeries, including electrosurgery. The tightness you are feeling could be due to several factors, including scar tissue formation, changes in the anal sphincter muscle, or even psychological factors related to the surgery. The anal sphincter is a muscle that can become tense or spastic, leading to difficulties in bowel movements and a sensation of tightness.
To help alleviate this tightness and improve bowel movements, consider the following strategies:
- Dietary Changes: Increase your fiber intake through fruits, vegetables, and whole grains. This can help soften stools and make them easier to pass.

- Hydration: Ensure you are drinking plenty of water throughout the day to help prevent constipation.

- Warm Baths: Continue with warm sitz baths, as they can help relax the anal muscles and provide relief.

- Gentle Stretching: Some patients find that gentle anal stretching exercises can help. However, this should be approached cautiously and ideally under the guidance of a healthcare professional.

- Physical Therapy: Pelvic floor physical therapy can be beneficial. A specialized therapist can provide exercises and techniques to help relax the pelvic floor muscles.

2. Sexual Health Concerns: The inability to engage in sexual activity can be distressing, especially if you previously had a fulfilling sexual life. The feeling of a barrier or tightness during attempts at penetration can be related to both physical and psychological factors.
- Physical Examination: It’s essential to have a thorough examination by a healthcare provider to rule out any residual lesions or complications from the surgery. While it’s unlikely for warts (condylomas) to grow deep inside the anal canal, it’s crucial to ensure that there are no new growths or issues that could be causing discomfort.

- Psychological Factors: Anxiety and fear surrounding sexual activity can also contribute to the sensation of tightness. It may be beneficial to speak with a mental health professional who specializes in sexual health to address any psychological barriers you may be facing.

- Gradual Desensitization: If you are comfortable, consider gradually reintroducing anal play using lubrication and gentle techniques. This can help your body adjust and may reduce anxiety associated with penetration.

In summary, the issues you are experiencing post-surgery are not uncommon and can often be managed with a combination of dietary changes, physical therapy, and psychological support. It’s essential to maintain open communication with your healthcare provider about your symptoms and concerns, as they can provide tailored advice and interventions based on your specific situation. If you continue to experience significant discomfort or changes in your health, do not hesitate to seek further medical evaluation.

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