This is my third and hopefully last question. My parents have found out and encourage me to use their plan, so I now only really have once concern before I set up a surgery date. I've heard from other online sources that some people who get laser removal are left with scaring, desensitivity, or decreased pleasure or ability to have anal sex. Warts in one spot in particular, around the area under in the ears of the sphincter that's next to the perinium, seems very sensitive in an almost pleasureable way, and I'm worried removal will affect my ability to have anal sex in the future by either damaging nerve endings, decreasing the thickness of the membrane, or covering the area with scars. So I'd like to ask what the common and rare side effects of anal wart removal surgery typically are, and wether there are any incidents where patients have complained that their surgery had altered their ability to either have or enjoy anal sex. Thank you.

Welcome back. Your question arrived while I was logged in. Most users shouldn't expect nearly real-time replies!---

Thanks for your help! I'll be sure to talk to my surgeon before I set a date. Thank you!

Dr. Hook reminds me to say that surgical outcomes often depend on the experience of the surgeon. Before deciding on a specific surgeon, ask direct questions about how often and how many anorectal wart removal procedures they have done. In general, the more the better. You can also ask frequency of side effects and complications, but answers are more difficult to judge. We also advise gay men among our clinic patients to consult with local gay rights or social support agencies, which exist in most if not all urban areas. Those in your area likely will be able to recommend surgeons with the greatest experience and satisfaction of previous patients -- including their sensitivity to their patients' lifestyles and sexual orientation. You may have already done much of this sort of homework.
---

So I did talk with my colorectal surgeron. She said there was no way the warts would ever go away on their own and could possibly turn cancerous, hence why she recomends all anal warts get removed immediately. However, when I asked her about sideeffects she said that some damage to sensitivity is to be expected and that anal stenosis is a possible consequence of multiple surgeries, which is usually needed anyway since the warts come back very often for these types of surgeries. I'm at a loss of what to do. I was under the impression if I waited long enough they'd go away on their own, but she seemed very vehement that this wouldn't happen. That leaves surgery, but with all the awful sideffects I'm scared to have it. Is anal stenosis an easily treateable condition if it crops up, or will it be a permanant disability?

With apology, I cannot help with these questions. First, as I said above, I am not a surgeon and have absolutely no experience counseling patients on these issues. This kind of care is not provided in STD clinics or by most STD specialists. Second, even if I had that experience, I couldn't help. This is not a health care delivery service. We provide general information and sometime guidance, but we cannot and will not advise persons about medical care decisions. As I suggested above, your best bet probably is to ask for referral to another colorectal surgeon or proctolotist for a second opinion; or perhaps find a physician with lots of experience treating gay men, who should be pretty easy to identify in most urban areas.---

This is a link to the ASCRS page that my colorectal surgeon told me to check https://www.fascrs.org/patients/disease-condition/anal-warts-and-anal-dysplasia-expanded-information which says that anal warts will not go away on their own. I've seen this sited on a lot of other colorectal surgeon websites, using the exact same wording so I assume they all got it from this source. I really don't want to have anal surgery and risk losing my ability to enjoy anal sex, but I don't want to wait for them to go away on their own when they won't and might cause cancer.

As I have said, it simply is untrue that warts do not clear up on their own. They do. As I also said, information from surgeons who treat anorectal warts often does not reflect the true spectrum of disease. There are numerous other sources about genital warts that you probably should explore, including CDC (www.cdc.gov/std) and the American Sexual Health Association (www.ashasexualhealth.org). But this is not a debate and I'm not going to discuss it further.

---