What impact can an anorectal malformation or Hirschsprung's disease have on my perception of sexuality?

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Both physically and mentally, these congenital conditions can influence your sexuality. Physically, because the anatomy of your lower body is different from that of most men, or because you may have problems with the uncontrolled loss of stools or urine. Mentally, because as a child you have undergone many medical tests and treatments over the years and have experienced pain in your lower body, and maybe still. Click here for an overview of possible physical and psychological problems.

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How does my condition affect me when I enter into relationships?

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A lot has happened to your lower body during your childhood –and probably also after your childhood. You have had surgery early on. Your doctors and parents probably had to perform unpleasant and nasty procedures on you, for example when rinsing or stretching your anus. This can still have unintended effects. It is good to become aware of such effects. Then you can do something about it (either yourself or with the help of a sexologist), so that you can enjoy your body, intimacy and sex more in the future.

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Constraints

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You may unconsciously associate your lower body with pain and misery. This can prevent you from enjoying sex or even entering into relationships. It can also have another subconscious effect: you may have trouble setting boundaries when it comes to unwanted touches. After all, as a child, you have grown accustomed to being touched in these places by adults, and it often hurt too.

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Shame

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Maybe you wore or wear a stoma bag or use diapers to collect urine or faeces. Maybe you have a lot of scars on your lower body because of all the operations. Or maybe you're afraid of accidents or farting during sex and intimacy. Relaxing your abdomen causes these accidents sooner, but a relaxed body is also needed to enjoy sex. All this can evoke feelings of shame in you. Maybe even so bad, that you avoid sex and intimacy or don't feel like it at all anymore. It can help to discuss these feelings with your partner or a sexologist.

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"It didn't take long before it [no more shame for scar] just went well for me, in my opinion, say, believed that it's just the way it is. It took a few months, but that was it then. Let me say; after that it went well too."

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The shape of your lower body

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Especially with an anorectal malformation, your buttocks, anus and genitals can have a different build than that of most other people. This can lead to physical limitations for sex. Maybe not all sexual acts or positions are possible because of your build or maybe it hurts.

If you have Hirschsprung's disease, you may have a lot of scars or you may be wearing a stoma bag. Again, it can evoke feelings of shame in you and lead you to avoid intimacy. Yet you can and may also enjoy intimacy! Don't just carry it around with you, make your feelings discussible and, if necessary, seek the help of a sexologist or other expert.

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How does my condition affect masturbation//self-gratification?

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Do you have Hirschsprung's disease? Then masturbation works the same as for others. Do you have an anorectal malformation? Then it is possible that your genitals are laid out differently. For example, your penis may become less hard as a result of this. It may take longer before it is possible to stimulate yourself. Keep experimenting. A sexologist can also give you tips to help you with this.

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What sexual problems can play a role and what are possible solutions?

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Erectile dysfunction

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Are you having trouble getting an erection? This may be a complication of an operation you have had in the past. The intestine and anus are surrounded by all kinds of nerves that are important for sexual functioning. During an operation, these nerves and blood vessels can be damaged and this can lead to permanent complaints. A sex therapist can help you with this problem.

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Problems with incontinence or farting

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Are you afraid of losing urine or faeces uncontrollably, or farting during sex and intimacy? By being open about this to your partner, you can avoid uncomfortable situations. Not sure how and when to talk about this? You may call in the help of a sexologist or other therapist. Having contact with other people with the same difficulties as you (via patient associations) can also help you overcome barriers.

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Problems with ejaculation

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Are you having problems with ejaculation? This may have to do with a limited erection as a result of a previous surgery. Consult your family doctor, who can refer you to a urologist if necessary.

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Ejaculation in the bladder

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Does sperm not come out of your penis when you ejaculate? That's because the sperm goes in a different direction and ends up in your bladder. The ejaculation then stops. This in itself can't hurt. You can just as easily enjoy the orgasm and you just pee out the sperm later. However, it can be a problem if you want to have children. Consult your family doctor, who can refer you to a urologist if necessary.

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Do you have an anorectal malformation? Then it is possible that your genitals are laid out differently. For example, your penis may become less hard as a result of this. It may take longer before it is possible to stimulate yourself. Keep experimenting. A sexologist can also give you tips to help you with this.  

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How can I get professional support?

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In case of problems, you may contact your (former) chief practitioner. He or she will consider which specialist (e.g. urologist or sexologist) can best support you with certain problems. You can also contact your family doctor for a referral.