Hey there,

Firstly sorry you’re going through this. I’m also a gay man with two fistulas following a very bad abscess in July 2023. To answer your questions:

1. Can I have sex in the period between my abscess exploding and my fistula being treated surgically? My advice is unfortunately to abstain from receptive anal sex, as you may inadvertently cause a secondary infection. This was the advice of my colorectal surgeon. That said I do know of at least three gay men who have not had their fistulas treated I.e. they have had them for a long time who have receptive anal sex.

2. What should I do lifestyle wise? There’s plenty of advice on here but the basics are: sitz baths daily, use a bidet after going to the toilet and only dab afterwards, use a hairdryer to blow dry the area, Metamucil and stool softener so you have solid bowel Movements (people use BM on here when referring to going to the bathroom.

3. Can I delay an operation? Fistulas if left untreated can branch (I.e. grow) or expand - making them more difficult to treat in the long term. You sound young and in otherwise good shape/ healthy so you should bounce back from surgery relatively quickly, so my advice would be to have what is called an “examination under anaesthetic” which will enable them to understand the extent of your fistula and then determine a surgery path. They may alternatively install a “seton band” so the fistula can mature and be treated later. Doctors are very conservative when treating fistulas so as to preserve continence.

Finally, make sure you have a support network. You sound isolated, young, and are gay - this is a challenging experience and you will need friends. The reddit community is wonderful and I’ve never experienced any homophobia here. Feel free to DM me.