This topic is about someone who recently had an abdominoperineal resection (APR) and a permanent colostomy due to rectal cancer. Since the surgery, they have been experiencing severe pain around the anus, tailbone, and testicles, especially after standing or sitting for about 20 minutes. They are concerned about whether this level of pain is normal and when it might start to improve.

Here are some helpful insights and advice:

1. Rule out infection: Persistent or worsening pain can sometimes indicate an infection. It's important to have a doctor thoroughly evaluate the situation. If an infection is found, antibiotics and possibly a wound-vac system for large or deep wounds can help speed up healing.

2. Expect extended recovery: Recovery from this type of surgery can take a long time. Many people have reported that it took several months, sometimes up to a year, for perineal pain to ease. It's also common to experience lingering twinges as nerves heal slowly after such extensive pelvic surgery.

3. Communicate pain honestly: It's crucial to be open about your pain levels with your surgeon or oncologist. Don't try to minimize or endure the pain without speaking up. Clear communication is essential to ensure you receive adequate pain management.

4. Understand the impact of surgery: Major pelvic surgery involves significant tissue trauma, which can lead to prolonged discomfort as muscles and tissues heal. It's important to give yourself time and be patient with the healing process.