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Rectal Pain...why?
Feb 21, 2009

Dear Dr. Frascino:

I have been Poz for 8 years now. Undetectable and in good health. Meds are working. Counts pretty decent. All in all, life is good, except

4 years ago I had surgery for anal warts. I was smack in the middle of a med-interruption study group and the warts started to appear at the tail end of my second med-stop. Id seen this happen before with a small wart on my finger. Ts drop, the wart appeared. It was my divining-rod. I saw a procto, he did surgery and removed them (cutting and burning) and they didnt come back.

Heres the problem and the question. Ever since the surgery I can no longer have any kind of anal sex. Too much pain. Even a finger hurts. I couldnt take a cock if my life depended on it. I went back to the surgeon a few times and told him this and his answer was that it was all in my head and that there is no physical reason for the pain. Three times he told me this after checking inside. He told me that I must be remembering the pain of the surgery and thats whats causing the pain. Hes a reputable doctor but I gave up trying to solve the problem with him. Talked to a shrinkhe suggested toys on my own to slowly stretch it back open. No luck. Hurts like hell.

How can this be? I loved anal sex and size was never an issue. It was never a painful experience (except when I wanted it to be) and I still crave it. Now its gone. How could this be in my head if I still crave it and want it so badly? Could this be in any shape or form an HIV-related issue? Have you heard this story before?

Is there anything you can recommend? I realize that this is off-topic, but I also know that you have a sense of humor, a broad range of expertise and youve seen and heard it all. Any advice would be appreciated - - even if you dont post this.

Response from Dr. Frascino

Hi Pain in the Butt Guy,

It's possible the "cutting and burning" could have caused or contributed to your 'pain in the ass' problem. There may have been some scar tissue or the sphincter could have been overly "tightened" surgically. So what to do? I'd recommend you get a second opinion from an HIV-knowledgeable proctologist. If this was caused by the surgical removal of your anal warts, the problem may be ameliorated by an additional corrective procedure. The type of discomfort you are experiencing is not normal. As for "remembering the pain of the surgery" as a cause for your current problem, this seems a bit farfetched to me. After all, I'm assuming he used anesthesia during the procedure rather than just have you bite down on a nail, right? (Maybe rather than restoring a perfect a-hole, Dr. Scalpel actually is a perfect a-hole!) Hmm . . . that may have been a bit harsh, since this is really not my (medical) area of expertise. At any rate, I'd suggest you start with a second opinion and hopefully you'll soon be back (comfortably) in the saddle again.

Dr. Bob

Am I Safe?
Allergy Treatment and HIV

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