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Is anal sex safe post colectomy?

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Posted on Wed, 18 May 2016
Question: I had a total colectomy with a j pouch about 23 years ago. I'd like to try anal sex. Is it possible? Safe?
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Answered by Dr. T Chandrakant (1 hour later)
Brief Answer:
It is possible but not very safe.

Detailed Answer:
Hi.
Thanks for your query, albeit short, specific and an intricate one.

To recapitulate: Female/45 - had total colectomy with J-pouch 23 years ago - would like to try anal sex - your specific questions - 1) is it possible and 2) safe?

1) Anal sex is possible. With proper evaluation and initial trial with finger or so, feasibility should be assessed to make sure that the pleasure does not turn into a nightmare.
I hope you have Scopy at a regular interval.
The report can tell us the capacity of the pouch. Since it is almost 22 years ago that the surgery was done, it is possible that the capacity of the pouch is well developed and should pose no problem if it is so.
It is always better to take extra precaustion.
Once assessed and felt is sufficiently accommodating after scopy, you can try for it. You can frankly discuss the issue while at scopy done by sigmoidoscope or colonoscope. Knowing the exact situation is possible after telling your Endoscopist to watch for the feasibility.

The usual precaustion should be taken.
This is should be very slow, well lubricated, protected, absolutely non-painful confirming that no trauma is made at any stage.

2) As you know anal sex is not safe in any case and not a natural one to have it.
Every precaustion has to be taken.
Anal sex after J-pouch can be tricky as there are two openings inside.
You both have to practice all the safety precaustion.

I hope this answers both your queries, since this is a virtual clinical it is possible that there can be a gap of communication, hence please feel free to ask any further relevant queries if you feel that there is a gap of communication.

Please do not hesitate to share or ask anything that is on your mind.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. T Chandrakant (21 hours later)
Thank you for your response. I do have a couple of follow up questions. My understanding is that when I had my surgery, my rectum was removed and small intestine was connected directly to my anus. I've read online that the small intestine, unlike the colon, is not expandable and also that the anus, without a rectum, is also not expandable. The sources I read said that since the opening and small intestine are not expandable, there's a strong likelihood of them being injured. Do you think that is correct?
My second question relates to what you said about getting a scopy on a regular basis. I haven't had a scopy since I had pouchitis 7 years ago. Why should have a scopy regularly if I'm not having problems?
doctor
Answered by Dr. T Chandrakant (9 hours later)
Brief Answer:
As explained below.

Detailed Answer:
Thank for your appreciation.
Read your follow up questions; I can understand that you must have seen online information and also might have interacted with online groups.

You have read the correct information, that is available online.
This is the necessity of having actual examination, endoscopy of the area so that the feasibility can be known exactly.
Your history says you had pouchitis 7 years ago and you have not undergone any scopy since then.
At least one scopy should have been done to see the present condition, which helps to see that there is no pauchitis or any other problems that has developed and your scopist can tell you the present situation, can tell you whether anal intercourse can be tried/done/ potential dangers are present or not.
It is better to be sure and safe than say sorry later.
Since you want to try, you should be sure about it and this is possible.

Second question: The centers which are specialized into J-pouch advocate review scopy as there always be a part of the rectum to which the small intestine is attached to. You can exactly know the condition inside and this is done ''to rule out'' that there is no problem.

Just out of the way discussion:
We use the small intestinal transposition in cases where there is vaginal agenesis (absence since conception) and acts perfectly well as new vagina successfully.
In case if J pouch: Since it retains the fecal matter, it ought have got enlarged and adapts to the new work it has to do. Hence should not have any problems.

I hope this clears your doubts further, please feel free to interact further as needed or if you feel that there is a gap of communication.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 19024 Questions

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Is anal sex safe post colectomy?

Brief Answer: It is possible but not very safe. Detailed Answer: Hi. Thanks for your query, albeit short, specific and an intricate one. To recapitulate: Female/45 - had total colectomy with J-pouch 23 years ago - would like to try anal sex - your specific questions - 1) is it possible and 2) safe? 1) Anal sex is possible. With proper evaluation and initial trial with finger or so, feasibility should be assessed to make sure that the pleasure does not turn into a nightmare. I hope you have Scopy at a regular interval. The report can tell us the capacity of the pouch. Since it is almost 22 years ago that the surgery was done, it is possible that the capacity of the pouch is well developed and should pose no problem if it is so. It is always better to take extra precaustion. Once assessed and felt is sufficiently accommodating after scopy, you can try for it. You can frankly discuss the issue while at scopy done by sigmoidoscope or colonoscope. Knowing the exact situation is possible after telling your Endoscopist to watch for the feasibility. The usual precaustion should be taken. This is should be very slow, well lubricated, protected, absolutely non-painful confirming that no trauma is made at any stage. 2) As you know anal sex is not safe in any case and not a natural one to have it. Every precaustion has to be taken. Anal sex after J-pouch can be tricky as there are two openings inside. You both have to practice all the safety precaustion. I hope this answers both your queries, since this is a virtual clinical it is possible that there can be a gap of communication, hence please feel free to ask any further relevant queries if you feel that there is a gap of communication. Please do not hesitate to share or ask anything that is on your mind.