A Clean Body During Prayer

Due to a medical problem I have difficulty with cleanliness of the anal area. A few questions.
 
 A. What is the halacha if, when sitting with the anus somewhat closed, it is clean — is that sufficient, or must one sit in a relaxed position, in which it is still not clean?
 
 B. In a situation where one is unable to become completely clean, should one refrain from praying altogether, and what is the law with regard to Kriat Shema and tefillin?
 
 C. How long must one try to clean oneself, or if it seems to me that it will not work anyway, is there no need to make the effort?
 
 D. Must one make up a prayer that was not prayed due to lack of cleanliness?
 
 I asked a question last week, but for some reason it is impossible to open the answer; I would be happy to receive the answer again.
 
 I wanted to ask about a person who is dealing with an emotional problem that makes his day‑to‑day functioning difficult
 as a result of lacking a mother figure in infancy. He is in regular talk therapy, but sometimes he needs urgent help and finds it beneficial to call support hotlines. Is it permitted to call and speak with a female operator, even though he derives enjoyment from the fact that it is a woman, and does it make a difference if he specifically requests a woman?
 
 Of course he does not know and is not acquainted with the operator.
 Thank you very much for the opportunity to ask and receive daat Torah.
 I would be glad to receive an answer.

Shalom u’vracha,

A person who does not suffer from lack of control over his bodily functions (a truly rare situation when he does) is able to clean himself properly according to halacha.

The common issue in this matter is an inability to decide that the body is indeed clean. If this is in fact the problem, then the halachic approach to the questions that arise from it must be in accordance with that.

--

Regarding your previous question: if you derive enjoyment from the fact that you are speaking with a woman, this is forbidden even if you do not know her and are not acquainted with her.