Anal Sex and Recovering After Surgery

If there is a topic that is virtually guaranteed to make patients clam up and hesitate to ask their surgeon a question they really want to know the answer to, this is the one—anal sex after surgery.

Talking about sex with a surgeon is hard enough, but add the word anal, and no one wants to ask the question. What about anal sex and surgery? First, let's clarify what anal sex and surgery mean.

Close-up of couple's legs in bed together
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Can Anal Sex Lead to Surgery?

The first question, can anal penetration lead to injury and surgery? Yes. It isn't common, but it is possible to have serious complications from anal sex.

In some cases, a foreign body can become lodged in the rectum and require surgery to be removed. This is typically associated with the use of sex toys or other objects for sexual pleasure, but can also be the result of sexual assault or even the ingestion of a foreign object that gets stuck on its way out of the gastrointestinal (GI) tract.

In other cases, vigorous anal sex, whether it is sexual intercourse or performed with an object, can lead to a serious condition called a rectal perforation. This is when the object punctures a hole in the thin tissue that is the rectal wall.

This tear in the wall can then allow stool to leak into other areas of the body, which quickly leads to a serious or even life-threatening infection. The treatment for this type of injury is often surgery.

Injuries, in general, are more likely to happen with a foreign object (even a sex toy) than with vigorous penetration.

There is also research that indicates that participating in anal sex can lead to an increased risk of anal cancer which typically leads to surgery, but again, the risk is low.

When Anal Sex Is Safe After Surgery

Now, as for anal intercourse after surgery, that answer is a complicated one. There are multiple reasons why anal sex may not be safe after surgery, and plenty of reasons why it may be perfectly safe to return to your normal sex life after surgery.

If your surgery had nothing to do with your genital or abdominal areas, follow your healthcare provider's instructions for your recovery. For example, if you had rotator cuff surgery on your shoulder and your healthcare provider advised that you take it easy for a week, plan on refraining from sex for a week.

If your surgery was abdominal in nature, such as a hysterectomy, and your healthcare provider said no sex for six weeks, that means anal sex as well as vaginal sex.

Why is this the case? Your surgery may have taken place in your abdomen, but there is only a thin membrane between your rectum and your abdomen (the same membrane mentioned before that can become perforated).

It isn't a good idea to have either type of sexual intercourse if you have healing internal organs. The pressure and the motion is the problem, not necessarily whether you are having rectal or vaginal intercourse.

Now, if your surgery was done on your rectum, anus, or colon, you will need to have a frank conversation with your healthcare provider. Only your healthcare provider will know the extent and nature of the surgery and be able to give you a safe time frame for resuming sexual activity.

If you had hemorrhoid surgery, rectal surgery, intestinal (particularly the large intestine), anal/anus, prostate or perineal surgery or a procedure that was referred to as a "prolapse" into or out of the rectum, wait until your surgeon says it is OK to have anal sex.

Cleanliness Is a Must During Anal Sex

Anal sex after surgery should have a certain amount of focus on keeping the surgical site clean, regardless of location. Using a condom can help prevent the transfer of bacteria during and after surgery, in addition to helping prevent sexually transmitted diseases. 

Trace amounts of stool could be disastrous to a new or healing incision by causing infection. Quickly discarding a used condom after anal sex is the best way to prevent this type of accidental transfer.

Talk to Your Surgeon About Anal Sex

Do not be embarrassed to ask questions about anal sex. A colon rectal surgeon has likely heard this question dozens if not hundreds of times in the past, so do not allow feeling bashful prevent you from getting the information that you need to safely return to your normal sexual activity. 

Just remember, if your healthcare provider was bashful about talking about things in the rectum, around the rectum, and going in and out of the anus they probably wouldn't have specialized in colon rectal surgery. Just remember, it is a lot easier to ask the question than find out the hard way that it was not a good idea or way too soon!

A Word From Verywell

Your surgeon isn't going to be shocked if you ask about anal sex during your meeting. In fact, it won't even be close to the strangest question they have ever had from a patient. If you are having surgery that pertains to the colon or rectum, you will want to get specific instructions from your surgeon about when this activity is safe.

If you are having surgery that is not associated with the colon and rectum, in general, you can follow the instructions for when it will be safe to return to "full activity" after surgery.

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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

  2. American Society of Colon and Rectal Surgeons. Anal cancer.

  3. Colon & Rectal Surgery Associates. Abdominal surgery post-operative instructions.