We’re taught many things about sex, growing up – although admittedly, nowhere near enough as we should be as gay men – mostly to use condoms if we don’t want AIDs (an attempt at outdated education from our parents if we’re lucky).
But there’s lots to do with gay sex that, some of us as adults, are still yet to learn. We caught up with Dr. Evan Goldstein of Bespoke Surgical to divulge the details of a common booty injury; anal fissures.
A fissure is a small tear or rip in the lining of the anus, often caused by rough sex, big dicks and gargantuous dumps. They can range from mildly discomforting to excruciatingly painful, and can leave behind scars that give butt holes that “used” look.
What preventative measures can I take to avoid getting them?
“The best bottoms either consistently bottom (doctor’s orders) or use dilators to assist stretching for acceptance and toughening the external entry point in between bottoming. Also, never forget – lots of lube. You can never have too much, and silicone works the best for anal engagement. In addition, proper positioning for entry is key and continued control even if it becomes more aggressive as you get going.
And lastly, choose the right size for the right pelvis. If you are a petite bottom, huge dicks sometimes simply can’t and shouldn’t be allowed to enter.”
We think that’s doctor speak for, ‘don’t have eyes bigger than your hole’.
How do I know if I have one?
“The most common post-fissure symptoms consist of pain, both during and after defecation and/or if one attempts anal intercourse (some may not see this as obvious, but bottoming is only going to make it worse!). Bright red bleeding could also be seen either in the bowl itself or streaking the sides of your excrement.”
What to do if I get one?
“The simplest recommendation: take a break and cease bottoming. Next, drink plenty of liquids and please use stool softeners. Epsom salt baths, non-steroidal’s (like Ibuprofen or Motrin), suppositories (like Calmol-4 or Preparation H), and a prescription for both muscular relaxers and numbing creams (Cardizem or Nifedipine with lidocaine) are imperative to assist acute fissures in healing.”
How long will it take to heal?
It can take a week or two to finally heal and one can certainly have some periodic setbacks during this process, so don’t get discouraged. If it seems all has healed, and you’ve been using the bathroom without issues for some time, then try using a small butt plug. Slowly dilate and see how it fares.
If the fissure just doesn’t seem to heal with conservative medical management, surgical evaluation is the next step. Don’t fret—the pain from surgery isn’t much different than what you have been suffering with already.
If needed, what can I expect from surgery?
The tissue needs to be cut out (called a fissurectomy), cleaned out, and encouraged to heal with a stronger scar. Another key surgical component is using Botox in the muscle and skin lines which allows not only relaxation to heal in the immediate post-operative period, but also assists in post-dilating encouragement of scar formation in the region.
Got a question about your booty health? Send it to us at [email protected] in confidence, and Dr. Goldstein will answer!