Tales from the Tail — I Lost My Hole

Dr. Evan Goldstein
Oct 15 · 4 min read

Client’s Tale

16 years ago, when I was still in my 20’s, I nearly bled to death from ulcerative colitis. It wound up destroying my colon and rectum. This type of colitis is a horrific disability and it’s severity can range from mild to clearly, as in my case, quite significant. The body basically attacks your insides and, more specifically, portions of the colon down to the rectum or it’s entire segment. And you guessed it — the area where your cock would be entering me may be involved as well. Poor you? No, poor fucking me.

Depending on the type of colitis and its severity, both will determine all of the available medical and surgical options. Of course, my type was the “fuck me” type (and not in good way). I had to have everything surgically removed. When I say everything, I mean everything: my entire colon and rectum to the point where they literally had to sew my asshole shut. Emergency doesn’t even begin to describe my situation. I was gushing blood out of my entire ass. My blood pressure dropped. It was horrifying. I had already been diagnosed with ulcerative colitis, which was being managed with medicine (though clearly not very well), but that’s a story for another time. In order to save my life, they said goodbye to all of my insides, as the mainstay of any surgical treatment for my degree of ulcerative colitis is complete eradication. Jesus H. Christ!

Had I known that my sex life and quest for love would end right then and there, I would have asked to be allowed to die. Years have passed and I still can’t accept it. I haven’t had sex in 16 years. Do you fucking believe it?

I wanted to bring to your attention my loss and how devastating this can be for pure bottoms — regardless of how it occurred. Also with the hope that some sort of prosthetic hole could be developed or for some lucky ones, with still an anal canal, they would be able to dilate their stump (literally). Why not, right? What really are the options, if any? We can put people on the fucking moon, but we can’t make me a functional asshole?

For now, I guess I can only continue to hope we discover a medical advancement in my lifetime.

My Discussion

Losing the ability to engage anally is devastating. I see how it affects not only the patient themself, but also the relationships connected to that hole. For the majority, it’s definitely debilitating, but it’s transient — more like 3–5 months off the horse. That, in and of itself, seems catastrophic. So you can imagine the few who learn that they will never be able to bottom again.

Thankfully, it’s not often. However, periodically, I will see patients who, for some reason or another, have lost the ability to bottom. In this patient’s case, it was the ulcerative colitis that lead to complete colectomy. The inflammation is so abundant that it renders the colorectal system non-functional and can increase one’s cancer risk, which is quite elevated. His case was due to excessive bleeding, but for many it is an elective choice with much thought and discussion on the topic at hand and it’s unfortunate consequences.

For anyone living with a chronic condition, such as this, I beg you to make sure you disclose, not only your sexual orientation, but also your full sexual desires. The choices we make or that may be chosen for you may not be as informed as we would hope.

For instance, patients with ulcerative colitis could have their entire colon and proximal rectum removed, all the while leaving the distal rectum and anal region intact. Yes, the cancer risk would be higher, but one could be continuously monitored with frequent sigmoidoscopies and, in theory, still be able to utilize this orifice for some element of sexual play. There are many different scenarios as it relates one’s chronic condition with a multitude of options available. These decisions should be based on scientific rationale with studies to support the causes, though the risk-benefit ratio should also include how one sexualy engages. I know this is never taken into account and/or discussed to the degree that it should, especially when it comes to anything that can have such a catastrophic ending. And honestly, that’s total fucking bullshit.

Dick-in-ass is a necessity for many and you need a functioning, winking asshole in order to do so. Without it, it ain’t gonna be possible. I think it is so important to share this poor gentleman’s story and I am beyond grateful for them reaching out. Life’s lessons are learned through the improper and unfortunate outcomes of many. It’s how we (hopefully) evolve and prevent these tragedies from happening to others in the future.

To me, the most important thing is this patient is alive despite his exsanguination. But to him, what’s having a heartbeat if you can’t achieve sexual fulfillment? We all have our own priorities. And it’s not for you or me to decide how we rank them.

Don’t forget to stay in touch on Instagram: me and Bespoke Surgical.

Dr. Evan Goldstein

NY | LA Gay Surgeon discussing ASS: A\rt, S\cience, and S\ex www.bespokesurgical.com/

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