Does Proctologic Surgery Really Influence Sexual Behaviors?

Author(s): Alessandro Sturiale*, Bernardina Fabiani, Raad Dowais, Felipe Celedon Porzio, Gaetano Gallo, Jacopo Martellucci, Claudia Menconi, Riccardo Morganti, Gabriele Naldini

Journal Name: Reviews on Recent Clinical Trials

Volume 16 , Issue 3 , 2021


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Graphical Abstract:


Abstract:

Introduction: The percentage of the heterosexual population that has experienced and regularly has anal intercourse ranges from 20% to 35% in the USA. This practice increases to 95% in certain populations, including lesbian, gay, bisexual, and transgender people. Due to the lack of data in the literature about the effect of proctologic surgery on anal intercourse, this study aimed to assess the impact of this surgery on sexual behavior in both genders.

Materials and Methods: From March 2016 to February 2018, an anonymous questionnaire was submitted to all patients aged >18 who had undergone proctologic surgery in one of two surgical units at tertiary referral centers and was assessed independently of gender. The exclusion criteria were incomplete healing and <3 months follow-up.

Results: In total, 929 patients answered the questionnaire in full. The overall prevalence of preoperative anal intercourse was 22.5%. The rate of anal intercourse among men was 16.7%, while among women, it was 28.9%. The overall postoperative rate of anal intercourse was 11.8%. The rate of postoperative anal intercourse among those who regularly engaged in anal intercourse preoperatively was 52.6%, with a 47.4% rate of non-completion (p <0.0001). The experiences reported during intercourse after surgery were mainly pain, stiffness, and partner discomfort.

Conclusion: Considering the statistically significant postoperative AI abandonment rate following all types of proctologic surgery, the surgeon has a duty to both treat the disease and to inform the patient about the possible consequences regarding its influence on anal intercourse.

Keywords: Anal intercourse, proctologic surgery, sexual behavior, hemorrhoid, anal sex, stapled hemorrhoidopexy.

[1]
Markland AD, Dunivan GC, Vaughan CP, Rogers RG. Anal intercourse and fecal incontinence: Evidence from the 2009-2010 national health and nutrition examination survey. Am J Gastroenterol 2016; 111(2): 269-74.
[http://dx.doi.org/10.1038/ajg.2015.419] [PMID: 26753893]
[2]
Owen BN, Brock PM, Butler AR, et al. Prevalence and frequency of heterosexual anal intercourse among young people: A systematic review and meta-analysis. AIDS Behav 2015; 19(7): 1338-60.
[http://dx.doi.org/10.1007/s10461-015-0997-y] [PMID: 25618257]
[3]
Gorbach PM, Manhart LE, Hess KL, Stoner BP, Martin DH, Holmes KK. Anal intercourse among young heterosexuals in three sexually transmitted disease clinics in the United States. Sex Transm Dis 2009; 36(4): 193-8.
[http://dx.doi.org/10.1097/OLQ.0b013e3181901ccf] [PMID: 19265740]
[4]
Shankle MD. The handbook of lesbian, gay, bisexual, and transgender public health: A practitioner's guide to service. New York: Harrington Park Press 2006.
[5]
Angela pattatucci aragon: Challenging lesbian norms: Intersex, transgender, intersectional, and queer perspectives. 2006.
[6]
Richters J, de Visser RO, Rissel CE, Grulich AE, Smith AM. Demographic and psychosocial features of participants in bondage and discipline, “sadomasochism” or dominance and submission (BDSM): Data from a national survey. J Sex Med 2008; 5(7): 1660-8.
[http://dx.doi.org/10.1111/j.1743-6109.2008.00795.x] [PMID: 18331257]
[7]
Vern LeRoy, Bullough B. Human sexuality: An encyclopedia. Routledge: Abingdon, 1994.
[8]
Hunko C. Anal sex: Let us get to the bottom of this. 2009. Available at: https://www.youtube.com
[9]
Hawley JC. LGBTQ America today: An encyclopedia. Greenwood: New York, 2008.
[10]
Bullough VL, Bullough B. Human sexuality: An encyclopedia. Routledge: Abingdon 2003.
[11]
Leichliter JS, Chandra A, Liddon N, Fenton KA, Aral SO. Prevalence and correlates of heterosexual anal and oral sex in adolescents and adults in the United States. J Infect Dis 2007; 196(12): 1852-9.
[http://dx.doi.org/10.1086/522867] [PMID: 18190267]
[12]
Mosher WD, Chandra A, Jones J. Sexual behavior and selected health measures: Men and women 15-44 years of age, United States, 2002. Adv Data 2005; 362: 1-55.
[PMID: 16250464]
[13]
Cáceres CF, Marín BV, Hudes ES, Reingold AL, Rosasco AM. Young people and the structure of sexual risks in Lima. AIDS 1997; 11(Suppl. 1): S67-77.
[PMID: 9376104]
[14]
Lane T, Pettifor A, Pascoe S, Fiamma A, Rees H. Heterosexual anal intercourse increases risk of HIV infection among young South African men. AIDS 2006; 20(1): 123-5.
[http://dx.doi.org/10.1097/01.aids.0000198083.55078.02] [PMID: 16327330]
[15]
Laumann EO, Gagnon JH, Michael RT, Michaels S. National health and social life survey. United States 1992. Available at: https://www.icpsr.umich.edu/web/HMCA/studies/6647
[16]
McBride KR, Fortenberry JD. Heterosexual anal sexuality and anal sex behaviors: A review. J Sex Res 2010; 47(2): 123-36.
[http://dx.doi.org/10.1080/00224490903402538] [PMID: 20358456]
[17]
Houston AM, Fang J, Husman C, Peralta L. More than just vaginal intercourse: Anal intercourse and condom use patterns in the context of “main” and “casual” sexual relationships among urban minority adolescent females. J Pediatr Adolesc Gynecol 2007; 20(5): 299-304.
[http://dx.doi.org/10.1016/j.jpag.2007.01.006] [PMID: 17868897]
[18]
Bakker F. Seksuele gezondheid in Nederland 2009. Available from: https://fiom.nl/sites/default/files/files/RNG_rapport-seksuele-gezondheid-in-nederland-2009.pdf
[19]
ISTAT: La popolazione omosessuale nella società italiana Report 2011. Available at: https://www.istat.it/it/archivio/62168
[20]
Statistics Canada: Same-sex couples and sexual orientation by the numbers, 2015. Available at: https://www.statcan.gc.ca/eng/dai/smr08/2015/smr08_203_2015
[21]
Kraus F. GAYS, BISEXUALS AND LESBIANS: SEXUAL MINORITIES ANCHORED TO THE LEFT, 2012. Available at: https://www.ifop.com/publication/minorites-sexuelles-ancrees-a-gauche/
[22]
McGee H, Rundle K, Donnelly C, Layte R. The Irish Study of Sexual Health and relationships Sub-Report 2: Sexual Health Challenges and Related Service Provision. Royal College of Surgeons in Ireland. Report, 2008. Available at: https://repository.rcsi.com/articles/report/The_Irish_Study_of_Sexual_Health_and_relationships_Sub-Report_2_Sexual_Health_Challenges_and_Related_Service_Provision/10770311/1
[23]
Gates GJ, Newport F. GBT percentage highest in DC, lowest in North Dakota. Gallup, 2013. Available at: https://news.gallup.com/poll/160517/lgbt-percentage-highest-lowest-north-dakota.aspx
[24]
Richters J, Altman D, Badcock PB, et al. Sexual identity, sexual attraction and sexual experience: The Second Australian Study of Health and Relationships. Sex Health 2014; 11(5): 451-60.
[http://dx.doi.org/10.1071/SH14117] [PMID: 25376998]
[25]
Underwood SG. Gay men and anal eroticism: Tops, bottoms, and versatiles. CRC Press: Boca Raton, 2003.
[26]
Dodge B, Herbenick D, Fu TC, et al. Sexual behaviors of U.S. men by self-identified sexual orientation: Results from the 2012 national survey of sexual health and behavior. J Sex Med 2016; 13(4): 637-49.
[http://dx.doi.org/10.1016/j.jsxm.2016.01.015] [PMID: 26936073]
[27]
Odets W. The shadow of the epidemic: Being HIV-negative in the age of AIDS. Duke University Press Books: Durham 1995.
[28]
Carroll JL. Discovery series: Human sexuality. Boston: Cengage Learning, 2012.
[29]
JoAnn Loulan. Lesbian Sex. San Francisco: Spinsters Ink 1984; p. 53.
[30]
Cohen JN, Byers ES. Beyond lesbian bed death: Enhancing our understanding of the sexuality of sexual-minority women in relationships. J Sex Res 2014; 51(8): 893-903.
[http://dx.doi.org/10.1080/00224499.2013.795924] [PMID: 23924274]
[31]
Nelson RL, Abcarian H, Davis FG, Persky V. Prevalence of benign anorectal disease in a randomly selected population. Dis Colon Rectum 1995; 38(4): 341-4.
[http://dx.doi.org/10.1007/BF02054218] [PMID: 7720437]
[32]
Siproudhis L, Pigot F, Godeberge P, Damon H, Soudan D, Bigard MA. Defecation disorders: A French population survey. Dis Colon Rectum 2006; 49(2): 219-27.
[http://dx.doi.org/10.1007/s10350-005-0249-8] [PMID: 16362804]
[33]
Bleday R, Pena JP, Rothenberger DA, Goldberg SM, Buls JG. Symptomatic hemorrhoids: Current incidence and complications of operative therapy. Dis Colon Rectum 1992; 35(5): 477-81.
[http://dx.doi.org/10.1007/BF02049406] [PMID: 1568400]
[34]
Kekez T, Bulic K, Smudj D, Majerovic M. Is stapled hemorrhoidopexy safe for the male homosexual patient? Report of a case. Surg Today 2007; 37(4): 335-7.
[http://dx.doi.org/10.1007/s00595-006-3378-3] [PMID: 17387569]
[35]
Mlakar B. Should we avoid stapled hemorrhoidopexy in males and females who practice receptive anal sex? Dis Colon Rectum 2007; 50(10): 1727.
[http://dx.doi.org/10.1007/s10350-007-9018-1] [PMID: 17687609]
[36]
Ravo B, Amato A, Bianco V, et al. Complications after stapled hemorrhoidectomy: Can they be prevented? Tech Coloproctol 2002; 6(2): 83-8.
[http://dx.doi.org/10.1007/s101510200018] [PMID: 12402051]
[37]
Gallo G, Sacco R, Sammarco G. Epidemiology of hemorrhoidal disease. In: Hemorrhoids coloproctology. Cham. Springer: New York 2018; 2: pp. 3-7.
[38]
Hokkanen SR, Boxall N, Khalid JM, Bennett D, Patel H. Prevalence of anal fistula in the United Kingdom. World J Clin Cases 2019; 7(14): 1795-804.
[http://dx.doi.org/10.12998/wjcc.v7.i14.1795] [PMID: 31417925]
[39]
Gallo G, Martellucci J, Sturiale A, et al. Consensus statement of the Italian society of colorectal surgery (SICCR): Management and treatment of hemorrhoidal disease. Tech Coloproctol 2020; 24(2): 145-64.
[http://dx.doi.org/10.1007/s10151-020-02149-1] [PMID: 31993837]
[40]
Sugrue J, Mantilla N, Abcarian A, et al. Sphincter-sparing anal fistula repair: Are we getting better? Dis Colon Rectum 2017; 60(10): 1071-7.
[http://dx.doi.org/10.1097/DCR.0000000000000885] [PMID: 28891851]
[41]
Sturiale A, Fabiani B, Menconi C, Cafaro D, Celedon Porzio F, Naldini G. Stapled surgery for hemorrhoidal prolapse: From the beginning to the modern times. Rev Recent Clin Trials 2020; 16(1): 39-53.
[http://dx.doi.org/10.2174/1574887115666200310164519] [PMID: 32156241]
[42]
Pata F, Sgrò A, Ferrara F, Vigorita V, Gallo G, Pellino G. Anatomy, physiology and pathophysiology of haemorrhoids. Rev Recent Clin Trials 2021; 16(1): 75-80.
[PMID: 32250229]
[43]
Sena G, Gallo G, Vescio G, et al. Excisional haemorrhoidectomy: Where are we? Rev Recent Clin Trials 2021; 16(1): 54-9.
[PMID: 32189597]
[44]
Sturiale A, Martellucci J, Naldini G. Retained or expeled staples after transanal stapled surgery: This is the problem! J. Coloproctol. 2017; 37(4): 268-72.
[45]
Liu W, Sturiale A, Fabiani B, Giani I, Menconi C, Naldini G. Internal delorme’s procedure for treating ods associated with impaired anal continence. Surg Innov 2017; 24(6): 566-73.
[http://dx.doi.org/10.1177/1553350617723771] [PMID: 28778136]
[46]
Janssen E, Macapagal KR, Mustanski B. Individual differences in the effects of mood on sexuality: The revised mood and sexuality questionnaire (MSQ-R). J Sex Res 2013; 50(7): 676-87.
[http://dx.doi.org/10.1080/00224499.2012.684251] [PMID: 22963331]


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Article Details

VOLUME: 16
ISSUE: 3
Year: 2021
Published on: 07 July, 2021
Page: [322 - 328]
Pages: 7
DOI: 10.2174/1574887116666210526125202
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