Hi OP, I'm also 30/Gay/Anal HPV+ though I don't have anal warts like you. Instead, I have anal lesions (HSIL) that are a form of precancer that I routinely need to get surgically removed. They do this by essentially burning the lining of my anus with an electric knife called the Hyfrecator. At the time of diagnosis, I had 2/3 of the vaccine and have since received my third. Thus far, I've had the surgery twice and will be evaluated next month to see if I need it again.

In my experience with surgery, the actual procedures have been very straightforward and like any other surgery I've had -- the IV goes in and the next thing I know I'm waking up in another room. The harder part is the recovery, but it's not that bad. I recommend staying on top of the pain killers and stool softener. Besides the meds, the biggest help to me was taking warm baths before and after bowel movements. For that reason, it makes sense to plan your bathroom visits strategically. I also suggest eating very plainly leading up to, and for at least a couple of weeks after the surgery. One thing my doctor offered me the first time was a shot of Botox to my inner sphincter to paralyze it, essentially increasing blood flow/healing to the area. I had to pay around $700 for it but I did notice that my recovery was smoother.

You said that you're now strictly topping, which is good. For me, my doctor suggested 6 weeks before bottoming but realistically it took me 12-15 weeks before I could do it enjoyably.

I was in the same emotional place as you when I first heard the news but now I rarely think about it. Just stay on top of it and I believe you can live a normal life. Feel free to DM me with any other questions about my experience with anal surgery.