Facing life changes after an abdominoperineal resection (APR) can be daunting, especially when you already have a permanent ileostomy. This situation involves a person who has been living with a permanent ileostomy for four years after a total colectomy and is now preparing for an APR. They are understandably anxious about how this new surgery might affect their lifestyle, particularly concerning future sexuality and intimacy. They are seeking advice and reassurance from others who have undergone the same procedure.

Here are some insights and advice shared by others:

1. Physical impact and recovery:
- After APR, you can expect a "Barbie butt," which means the anal opening will be completely closed. The incision usually heals within a few months.
- Many people find that the recovery time after APR is similar to or even shorter than their initial ostomy surgery, although healing times can vary from person to person.

2. Sexuality and body image:
- If anal stimulation wasn't a part of your sexual experience before, most people report little to no change in sexual function after APR.
- Confidence is crucial. Try not to let the ileostomy or the closed perineum define you. Embrace your body and "own it."

3. Emotional adjustment:
- The emotional journey can take longer than the physical healing. It's important to take things one step at a time and be patient with yourself.
- Connecting with a community and sharing your progress with others who have experienced APR can be very helpful in coping with the changes.

4. General encouragement:
- Many people send their support and emphasize that resilience grows from these experiences. Remember, you are not alone, and you can lead a full life after APR.