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Doc, what are the risks related to extreme anal sex?

We spent so much time skulking on Efukt or Evil Angel we started wondering if all those extreme practices flourishing in porn weren’t a little harmful to the actors’ health. Since planet Earth revolves around the anus, and given how prolapsus is getting trendy these days, we needed some reliable and definitive medical advice on the matter. We therefore scheduled an appointment with proctological surgeon Nicolas Lemarchand, head doctor at the Hospital Paris Saint-Joseph, to show him our best fist-fucking and colored-enema gifs. A good sixty years old, he agreed to answer all our questions, in the purest “not impressed” style of the physicians who’ve seen it all.

Hello, doctor. Can an intensive practice of anal sex cause health problems?
No, there is no risk, no problem at all.

Even going from ass to mouth?
[Pointing the finger at the picture of a dilated anus] I’ve seen prettier ones than those! (Laughs) A priori, there is no major risk.

Not even with the injection of fecal matters or that kind of thing?
A priori, no major risk.


Then there are some more extreme things, like insertions for instance…
A priori no, there is no prolapsus… However, why on Earth would you want to shove this up your ass in the first place…?

So basically, you can stick almost everything possible and imaginable in your butt without harm?
The only problem is that, in this case she is lucky enough to expel it, but in general it doesn’t come out by itself. It means she already has a nice anal gap. She is experienced because most often, balls like this, you need to remove them under general anesthetic. She isn’t necessarily incontinent, though, it’s not an actual unavoidability.

What about the practice of enema?
I can’t figure out how the guys get it up with that thing. The primary problem with enema is you need to avoid wounding yourself with the bulb. Then, you shouldn’t overdo; it gives bad habits to the rectum and, in the end, you are likely to have trouble having a bowel movement. But that’s all. You can cleanse yourselves. Some people administer themselves enemas on a regular basis.

Then again, some people do it with a great variety of things, urine for example…
Ha yes, but you don’t give a toss about that. What matters is to not pour hot water because it could burn the rectum, but that’s it. As long as you don’t put anything toxic inside, it’s OK. If you pour liquids like alcohol, you will also burn the fragile rectal mucus membrane. But if you use warm water, there is no major risk. The only problem is you run the risk of hurting yourself with the enema nozzle if you’re not careful enough, but that’s all.

Let’s move on to fist-fucking or extreme insertions, here with Hotkinkyjo, who kind of specialized in that…
I’ve also got nicer pictures in that field! It’s not that far inside, actually. The problem is it can be dangerous if it’s not done right, because there is a bend between the rectum and the sigmoid at that level, and there is a risk of perforation. But if it’s performed gently, there is no hassie. The classic story is to perforate it by going in too roughly, with brutality rather than care. In this case, it seems it didn’t perforate…


How far can you go right ahead, more or less?
Until the bend I mentioned, i.e. about six inches deep. In the event of a perforation, you need to undergo emergency surgery. In this perspective, fist fucking can be dangerous, yes. Diameter-wise, a priori, there is no major risk. I never witnessed any case of incontinence among the people doing this. After a long fist-fuck, if there is the slightest pain, the smallest doubt, you need to rush to the hospital and get a Plain Abdominal X-Ray without preparation. If there is a risk of perforation, you need to perform urgency surgery on the patient. If the patient waits too long, it’s going to be peritonitis, two months with the bag, et cetera.

We also noticed the surfacing of rectal prolapsus in the recent years.
The thing is, the more you do that, the likelier you will need surgery, and the more trouble the surgeon will have fastening the prolapsus when surgery eventually becomes necessary.

Is it something that appeared with porn?
A rectum sticking out is not something normal. You don’t get this out of fist-fucking, but rather because the inner tissues tends to go down. Prolapsus isn’t related to sexual practices, it is constitutional. To push and pull hard like this, and to fist on a prolapsus may cause problems secondarily, in the repair process. Because the tissue is completely loose, the surgeon may have difficulties attaching it back. That’s the only risk. Ironically, with a prolapsus you should rather avoid getting fisted, but then… (Laughs)


We also wanted to ask you about 1 Guy 1 Jar, a guy who broke a jar inside his rectum.
I bet the guy enjoyed a colostomy in order to have his wounds heal over.

He was interviewed by Best Gore, a website displaying the worst of horrors, and he assured he never went to the hospital and removed the splinters of glass himself.
It’s possible.

But isn’t there a risk of sepsis?
Not of sepsis, no. But there is risk of hemorrhage, and if he bleeds too much, well… everything could happen. How long ago did he do that?

It was five years ago.
Five years and he didn’t experience any problem? It’s possible; some people are lucky. Glass cuts, it can make you bleed when it comes out… In the medical field, everything is possible. Some people really are jammy, but it generally turns out pretty bad. What you need to keep in mind is that a sphincter is tight, even if you have sexual relations. So to get something out, you have no choice but to push. And when you push glass, it cuts. He really got the breaks! He should have suffered lesions.


There’s also the whole saline injections trend: people injecting physiological saline in the tissues to swell them up.
Well that, in my opinion, is not harmless at all. I have no experience of this, but it is crazy. To my mind, there is a high risk of infection with the needle that isn’t clean, and could cause an abscess… Plus, I really cannot see the point.

In our understanding, in the sex realm, it would improve the sensitivity…
For me, it’s dangerous. There is a risk of infection, a risk of hematoma when you inject the saline… No, this is truly dangerous.

You said the girl with the ball was experienced, trained almost. Is it possible to loosen the sphincter (too much), in the end?
Theoretically, there is no incontinence. Then again, this is a relatively recent trend… It’s been around for some fifteen or twenty years. The trouble is more if you suffer from rectal prolapsus. Now, a girl getting fisted frontwise on a regular basis won’t feel any pleasure with someone “normal”, unless she is fisted. If taken to extremes, “normal” pleasure won’t exist anymore. You see what I mean? If you need a big dilatation to reach at least sixth heaven, it means you will never experience pleasure otherwise again. At least, that’s what I think.

And can it be irreversible?
For a girl who is used to being fisted in the vagina and anus, a dick is like a pinkie. For a guy, it’s all the same. He swims in there. I really cannot see the point. All the more so as such relations sometimes are sadomasochistic. A guy who is fisting often has a sadist side. But the only risk we should put emphasis on is the one involved in deep fisting. As from about six inches, there is a bend you need to take smoothly, and certainly not like some wild Mad Hatter! As for double fisting and fist smacks, no trouble, as long as you don’t push it further than the wrist. That’s all. Anyway… This doesn’t push my pants. (Laughs)


During your career, was there a particular case that struck your mind, something exceptional?
It’s rather about foreign bodies. As I said, you cannot evacuate them, most of the time. I’ve seen hideous dildos, apples… That’s what I said about the girl with her ball there. Candy turns into matter, but a solid ball is way different: it is round, and it takes a lot of efforts to expel that. She is able to do it, but spontaneously, you can’t. That set aside, no extraordinary traumas.

About all those SM leaning practices, the only advice I would give is: know when to say stop, and know when to stop. Otherwise, you can be brutal; you can do anything. You see these people fisting one another [pointing at the images]: there’s not a single drop of blood, and everything goes well. But if you do that to a guy or girl that doesn’t agree, it will very clearly not look that nice.

The trouble with all those things is the difference between love and rape. The gesture is the same, but in one case it is agreed to and done with the partner, not against him or her. In the latter case, harm will inevitably be done. Some guys get raped, some have a broom stuck up their ass, and though the lesions usually heal quickly, the moral wounds are not healed that easily… But that’s another problem.

What about the use of drugs and anesthetic lubricants?
Guys do that a lot. But I have no experience in that field.

One other thing. The dildo manufacturers! The number of sex toys you can insert but never manage to withdraw is phenomenal! Some are fine: they are fitted out with lines you can’t pass. But the standard dildo you got with no hindrance whatsoever, you play with it, you slip it in, and once it’s inside, you can’t pull it out again. You should tell that: beware of the dildos without buffer! They are hazardous! Once a foreign body has passed the sphincter, it is almost impossible to retrieve it without resorting to general anesthetic. And sometimes it’s a real pain pulling it out. If I came to swallow something [with his sphincter – Editor’s note], I would sue those dildo manufacturers’ ass. Again, it’s the story of the girl and the ball. Once it’s inside, you need to be put to sleep. In the vagina, there is a natural block, no trouble. But in the rectum…

So I’m sure you all understood: the anus is a formidable organ with exceptional dilatation capacities you nevertheless need to treat with care and respect. You thus should remember the following basic principles: mutual consent, consultation at the slightest pain, do not use sex toys without buffers, and don’t overindulge in enema. As for saline injections, in case it ever crossed your mind, keep off this shit.

Originally translated from this interview by Ms. Alice

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