Anal Sex After Stapled Hemorrhoidopexy

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Anal Sex After Stapled Hemorrhoidopexy

Question:

I am a married female. My doctor is recommending I have a stapled hemorrhoidopexy. Will I still be able to have anal sex afterwards?

Answer:

A "stapled hemorrhoidopexy" is a relatively new operation available for some types of hemorrhoids.

Hemorrhoids are lumps or masses of tissue in the anus. Hemorrhoids inside the anal canal can cause intermittent bleeding, usually with bowel movements. Hemorrhoids outside the anal canal primarily cause swelling and sometimes discomfort. Swelling and discomfort may occur intermittently, when the hemorrhoids become especially irritated. Many people have both internal and external hemorrhoids.

Hemorrhoids are not dangerous, so treatment is almost always optional. The choice of treatment depends upon the size and location of the hemorrhoids.

With a "stapled hemorrhoidopexy, a device is used to remove a ring of tissue just above the hemorrhoids. This pulls them back up inside the rectum and reduces symptoms. (This is done under anesthesia, as an outpatient.) The advantage of stapled hemorrhoidopexy is that it is less painful than traditional surgery, and does not require multiple treatments. It is not applicable if there are prominent external hemorrhoids. Since it is a relatively new procedure, the long-term effectiveness of stapled hemorrhoidopexy is not known. Experience so far, however, has suggested that it works well for the right type of hemorrhoids.

In the case of stapled hemorrhoidopexy, tiny metal surgical staples are placed in the lower rectum. These are permanent. The patient does not have any sensation from this, but if anal sex took place, a male partner might feel pain in the penis from the staples. So if you plan to continue anal sex after your hemorrhoid surgery, I would instead recommend one of the other alternative procedures.

For hemorrhoids that are small- to medium-sized and primarily internal, office treatments can include rubber band ligation, infrared coagulation, electrocoagulation, freezing therapy, and injection sclerosis. Of these, rubber band ligation seems to work the best. A small elastic is placed around the neck of the hemorrhoid. This strangles the hemorrhoid and makes it shrink. Patients may feel some discomfort for 24 to 48 hours afterwards, but it is usually not severe. When the hemorrhoid dies, the rubber band falls off unnoticed, and the small raw spot heals. Two to four office treatments are usually required to shrink the hemorrhoids and minimize the likelihood of their return.

For patients with large hemorrhoids or prominent external hemorrhoids, office treatments are not applicable. In this case, surgically removing the hemorrhoids is the best treatment. This is an outpatient operation done under anesthesia, usually with excellent results. Most patients want to take a week or 10 days off from work.

Serious complications are rare after any hemorrhoid treatment. Surgery always has a risk of infection, bleeding, or a drug or anesthesia reactions, but these are very unusual. Scarring and narrowing of the anal canal is a very small risk with surgery or stapled hemorrhoidopexy. There is a remote risk of serious infection or bleeding after hemorrhoid ligation. There is a small risk of bleeding after stapled hemorrhoidopexy. Rarely, patients can have an prolonged rectal discomfort after stapled hemorrhoidopexy. Irritation and stretching of the anal sphincter muscle during surgery or stapling can occasionally cause minor incontinence (difficulty controlling gas or a leaking of loose stool), but this is usually temporary, if it occurs at all. Recurring hemorrhoids are a risk after any treatment, but this occurs less than 10% of patients.

Last updated:	July 20, 2009