Post-Fistula Surgery: Anal Sensitivity and Sexual Activity

Anal intercourse after anal fistula?

Hello, doctor! Before my fistula surgery, I engaged in normal and safe anal intercourse, using lubrication and taking necessary precautions.
However, after the fistula surgery, I had a recovery period of six months during which I did not engage in anal intercourse.
Now, I have noticed that after sufficient lubrication and relaxation, my anus has become more sensitive and tense, and I experience a particular stinging sensation, although there is no bleeding.
It feels slightly red and swollen, and I have not attempted anal intercourse since then.
Therefore, I would like to ask if the fistula surgery can lead to increased sensitivity and discomfort in the anus, making anal intercourse more difficult, and whether it is possible that the recovery period after the fistula surgery has not fully healed, making this activity unsuitable at this time? Thank you, doctor.

Huǒchē shàngmiàn yǒu èyú, 20~29 year old female. Ask Date: 2021/03/11

Dr. Ke Fangxu reply Surgery

After fistula surgery, a scar tissue may form across the anal opening.
Since scar tissue lacks elasticity, discomfort may occur during anal intercourse due to the repeated stretching.
Theoretically, the wound should be fully healed six months post-surgery; however, discomfort may persist until the scar tissue is completely absorbed, which can take up to 1-2 years.

Reply Date: 2021/03/11

More Info

After undergoing a fistula surgery, it is not uncommon to experience changes in anal sensitivity and discomfort during sexual activities, particularly anal intercourse. The surgery itself can lead to the formation of scar tissue, which may affect the elasticity and sensitivity of the anal region. This is especially true if the surgery involved significant manipulation of the tissues around the anal canal.

Understanding Post-Surgery Sensitivity
1. Scar Tissue Formation: After any surgical procedure, including fistula surgery, scar tissue can develop. This tissue is typically less elastic than the surrounding healthy tissue. As a result, during anal intercourse, the scar tissue may not stretch as easily, leading to increased sensitivity and discomfort. The tightness and sensitivity you are experiencing could be attributed to this scar tissue.

2. Healing Process: The healing process after fistula surgery can vary from person to person. While six months is often considered a sufficient time for initial healing, complete recovery, including the absorption of scar tissue, can take much longer—sometimes up to a year or more. During this time, it is essential to be cautious with any sexual activities, as the area may still be sensitive and not fully healed.

3. Increased Sensitivity: Post-surgery, many individuals report heightened sensitivity in the anal region. This can manifest as discomfort or pain during anal intercourse, even with adequate lubrication. The sensation of tightness and the sharp pain you describe could be due to the heightened sensitivity of the nerve endings in the area as it heals.

Recommendations for Sexual Activity
1. Gradual Reintroduction: If you wish to resume anal intercourse, it is advisable to do so gradually. Start with gentle exploration and ensure that you are fully relaxed and adequately lubricated. Pay attention to your body’s signals, and if you experience pain, it is crucial to stop.

2. Consultation with Healthcare Providers: Given your concerns about sensitivity and discomfort, it may be beneficial to consult with your surgeon or a healthcare provider specializing in sexual health. They can assess your healing progress and provide personalized recommendations based on your specific situation.

3. Pelvic Floor Therapy: In some cases, pelvic floor therapy can be helpful. A physical therapist specializing in pelvic health can guide you through exercises that may help improve elasticity and reduce discomfort in the anal region.

4. Patience and Self-Care: Healing takes time, and it is essential to be patient with your body. Engage in self-care practices that promote relaxation and comfort, such as warm baths or gentle stretching exercises.

Conclusion
In summary, it is not unusual to experience increased sensitivity and discomfort in the anal region following fistula surgery. The formation of scar tissue and the healing process can significantly impact your experience during anal intercourse. It is crucial to approach sexual activities with caution and to seek guidance from healthcare professionals to ensure that you are healing properly and to address any ongoing concerns. Remember, your comfort and well-being should always come first.

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