Anal Sex and Recovering After Surgery

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As awkward as it may be, a surgeon will often need to have a candid discussion with you about sex—specifically anal sex—after certain types of surgery. This is not only true if you have undergone vaginal, anal, or colon surgery but also certain abdominal or pelvic surgeries.

This article explains the risks of anal sex after surgery and at what stage it is safe to have sex again. It also offers advice on ways to avoid infection or injury if engaging in anal sex after recovery.

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Anal Sex After Surgery

The question of anal sex after surgery is a complicated one. There are many situations where it may be perfectly fine to have anal sex. However, there are others when it can pose serious health risks.

If your surgery was abdominal, such as a hysterectomy, you will likely be advised to avoid vaginal and anal sex for six weeks. This is because there is only a thin membrane separating the rectum from the abdominal and pelvic organs. Anal sex can press on this membrane and cause damage to internal incisions. It can place undue stress on external incisions.

As a general rule, it is never a good idea to have sex immediately after surgery on any abdominal organ such as the liver, kidneys, or stomach. Even surgeries involving the thorax (chest cavity) may require the temporary avoidance of sex.

Your surgeon will also advise against having anal sex following rectal, colon, or anal surgery. This includes hemorrhoid surgery and prostate surgery. Depending on the type and extent of the surgery, you may need to avoid sex for six weeks or more.

If your surgery had nothing to do with your genital or abdominal areas, your surgeon may advise you to take a short break from sex. For example, if you had rotator cuff surgery on your shoulder, your surgeon may advise you to refrain from sex for a week just to be safe.

Anal Sex During Recovery

Even if your surgeon gives you the OK to have anal sex following anal or rectal surgery, remember that the tissues are still vulnerable and prone to tiny tears.

To avoid infection, keep the surgical site clean, washing the anus with warm water and soap. Using a condom can prevent the transfer of infection, including sexually transmitted ones

To avoid injury, use plenty of lubrication when engaging in anal sex. Water-based lubricants are ideal when using latex condoms as they don't damage the structure of latex like oil-based lubricants can. They are also less likely to be irritating.

Avoid flavored or scented lubricants as well as those containing the spermicide nonoxynol-9 which can be irritating to anal tissues.

Can Anal Sex Lead to Surgery?

It is possible to get injured during anal sex. In some cases, a foreign body can become lodged in the rectum and require surgery to be removed. These include sex toys and non-sexual objects used for sexual pleasure.

In other cases, vigorous anal sex with a toy or a penis can lead to rectal perforation. This is a serious condition in which a hole is punctured in the wall of the rectum. Certain people are at greater risk of rectal perforation, including those with rectal cancer or who have undergone anal radiation. People with diverticular disease (which causes weakened pockets in the colon) are also at risk.

Sexual assault and rape can also cause anal injury, sometimes severe.

A tear in the wall of the rectum or colon can allow stool to leak into deeper tissues of the body. This, in turn, can lead to a serious or even life-threatening infection. Surgery is the only remedy for a perforated rectum or colon.

Summary

Anal sex may need to be avoided after surgery as it can disrupt incisions and place excessive pressure on the surgical site. Sex should be avoided for six weeks following surgery on the abdomen or pelvis. Anal sex may need to be avoided for at least six weeks following anal, rectal, or colon surgery.

Even when it is OK to have sex following anal or rectal surgery, use plenty of lubrication to avoid damaging vulnerable tissues. Condoms should also be used to avoid infection.

Injuries can sometimes occur as the result of anal sex. Surgery may be needed if a foreign object is accidentally lodged in the rectum. Surgery may also be needed to repair the perforation of the rectum or colon during vigorous anal sex.

1 Source
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  1. Shaban Y, Elkbuli A, Ovakimyan V, et al. Rectal foreign body causing perforation: Case report and literature review. Ann Med Surg (Lond). 2019;47:66-69. doi:10.1016/j.amsu.2019.10.005

By Jennifer Whitlock, RN, MSN, FN
Jennifer Whitlock, RN, MSN, FNP-C, is a board-certified family nurse practitioner. She has experience in primary care and hospital medicine.