Hey all, so I'm a gay male who had a Lateral Internal Sphincterotomy in early December. From what the doctor said in the follow up appointment back in February, it seems to be healing normally.

My question is, will I ever be able to have receptive anal intercourse? There is at times a painful feeling, like a knot being tightened (that's how I describe it, I can't think of a better way) which has come up when I've tried exploring in that area. Is it too early since surgery for me to even think about sexual activities down there, or am I screwed for the rest of my life?

Thanks! :)

Hi there!

I'm a gay male as well and I'm kinda in the same boat as you, but to a lesser degree. I had a fissure maybe a month ago and it seemed to be healing okay, but I rushed back into receptive anal sex and hurt myself again (so giving myself at least a few more weeks of healing before attempting anything else). My advice is... give it time. Give it more time than you think you need, and especially more time than you want to give.

I've haven't had LIS for a fissure, but I did have a peri-anal haematoma the size of a pea removed a bit over a year ago. It was small but extremely painful, and the recovery ended up being awful. I thought that my sex life was gonna be ruined by it... right up until the point where it wasn't, and I was healed enough to have great receptive anal sex again.

So don't get yourself into a funk (you'll see many people on here saying a positive attitude is important!). Give it time, give your butt some TLC, and wait until you're feeling great before jumping back on the horse (or dick, to be more precise).

Best of luck!

Thanks! I just made an appointment with the doctor who did the surgery, it'll probably be an awkward conversation but I'm sure it's one he's had before.

Hi RTiluva,

So is there an update? I am a gay male as well. How is your sex life after the surgery? I may have to get it because I had a hemorrhoidectomy some years ago, and the scar tissue from that made things tighter down there. The surgical site tears open and bleeds every time I try to have sex. I am not sure that would be considered a fissure, but it makes sex so painful I dont even want to do it. I feel ruined. I think LIS could fix it, but I am afraid of the incontinence part also.

Hi Chillblue,

What you have would definitely be considered a fissure. Not only are you experiencing pain but having an open wound can you make you susceptible to infection so you want to make sure you get the treatment you need.

I understand/respect the fear of incontinence but it's a very low risk. The risk is even much much lower if you have the operation done by a colorectal surgeon instead of a general physician.

I havnt tried having anal receptive sex since my surgery (it's only been 4 weeks) but I'm confident the surgery was the right move for me and I look foward to being able to have sex again. The surgery doesn't ruin you. If anything it gives you a fresh start. A virgin bottom again

That would be amazing if this fixed the issue. My doctor hasn't offered it to me as a solution, and when i mentioned it he said he was reluctant to do it since my anal pressure seemed ok. But thats the problem. I know my body and to me it has always felt tighter after the surgery. Ive gone to 3 different CS and they can find nothing wrong with me. When I tear, it happens right at the surgical site of the hemmorhoidectomy I had some years back. By the time I can get an appointment to gave it looked at, its all healed up. Im so tired f this. Buttpalsteven, Can I ask why you decided to have LIS in the first place? What was your issue?

Sound like you may have anal stenosis. I have it from an old hemorrhoid surgery and a failed LIS. The scar tissue doesn't stretch. Mine was so bad I had double advancement flaps done. It helped a lot. I still have stenosis but it's functional now. Talk to your doctor about an advancement flap, that might help you.

I'm sorry that you are dealing with that after your surgery. I wish I could be more helpful.. Suzy's advice definitely seems worth bringing up to your doc.

To answer your question, I developed an anal fissure when I was 18 or 19 (not sure of the cause, could be from a hard stool or an ambitious night). I would have a BM Maybe once every 2 months that felt like I was passing glass. After that I'd have a week of bloody BM but the pain would alleviate. Tbh, I forgot what s normal BM felt like. Post - LIS pooping is more normal/smooth for me then I ever remember it being.

In terms of my medical treatment - My GP diagnosed me with hemorrhoids when I was 19. The next GP two years later diagnosed me the same way. Both recommended the typical conservative treatments - prep h, fiber, sitz baths, etc.. however I never healed. Finally went to a clinic instead of a GP and the doc said I don't have hemorrhoids but I have a large fissure. I tried his conservative treatment (zinc oxide). 2 years later (6 years of dealing with this) I finally called a CRS and scheduled an appointment. My fissure was very large so he recommended immediate surgery. I trusted him and went with it. I'm really glad I did.


However if your doc says your internal pressure isn't too tight, the surgery would be more risky for you (if it is too loose after the surgery = incontinence). It sounds like your Doc is committed to you though which is awesome, I'd try talking further with her. If you think she is wrong though it's definitely worth getting a second opinion. It's your health - you deserve a healthy and happy butt!

Hi Suzy. Thanks for your reply. I dont have stenosis according to all the doctors i went to. But i know things are more constricted than they were before my hemmorhoidectomy. All the doctors say the area looks good when they look at it. But when it tears it feels raw for a few days then it heals and is fine until it tears again. I am ok except for one spot that likes to open up if I have a hard bowel movement, a large bowel movement, or sex.

Buttpalsteven, so sorry to hear all you have been through. Doesn't make my problem seem so bad. Its almost been 10 years since my hemmorhoidectomy, and ive been dealing with this problem by not having sex as much lol. Its embarrasing and I lost a really good relationship because I was depressed about this all the time. It just feels hopeless at times. I wish I had never had the hemmorhoidectomy....

My doc did an examination where he put his finger in, and said the pressure was fine. I can handle a finger just fine lol. Sex is a major issue which was never a problem before the hemmorhoidectomy. I think theres some kind of test they can do with a machine. I really think the LIS would benefit me if it makes the opening larger.

Hello. I'm new to this forum and so desperate for answers from gay men who have experienced this. I'm scheduled for a LIS procedure in a couple of weeks. Like others in this forum I have a chronic anal fissure. My biggest concern is that this procedure will prevent me from ever having anal sex in the future. I've also read that the fissure will take up to a year to heal post-LIS. The CRS made it clear to me that incontenence will be minimal as my sphincter is "tight".