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Anal Intercourse
Feb 20, 2008

I am a 50 year gay male and I have been HIV+ for approximately 20 years. About a year ago I was diagnosed with bladder cancer. Even though there's no co-relation between bladder cancer and my HIV status, there is an indirect link since about 18 years ago I was diagnosed with non-hodgkins lymphoma and successfully underwent six months of CHOPS chemotherapy treatment. When I was diagnosed with the bladder cancer I was told that the CHOPS treatment I received is known to cause bladder cancer in some individuals.

After many months of BCG and mytomycine treatments, the cancer kept coming back. As a result, I deciced to have a my bladder removed and replaced with a neobladder built out of my small intestines. This procedure was done a month ago. My prostate was also removed in addition to two bundles of lymph nodes. Luckily for me, they were able to attach the neobladder to my urethra (thus hopefully enabling me to urinate normally through my penis) and preserve my nerve cells (which might eventually allow me to develop an erection and climax).

My question is as follows: As a gay male, I wonder what dangers to my neobladder there might be if I engage in receptive anal sex. The neobladder is positioned very close to the colon and I wonder if my engaging in anal intercourse might damage my neobladder or cause me to urinate uncontrollably during sex. I have always enjoyed sex as a top and as a bottom, but since I will be impotent for a while as a result of my surgery, I would still like to engage in sex, even if it means just being the receptive partner in anal intercourse. Have there been any studies that might shed some light on this matter? I am uncomfortable asking my doctor this question. Thanks for listening.

Response from Dr. Henry

I don't have any experience with a situation like you describe. If any reader can contribute either their own experience or a reference from a relevant published paper please post. KH

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