MEN: Sexual ability after ostomy surgery varies widely in males. The physical ability to achieve an erection is affected by whether or not the surgery damages the nerves that control erection and ejaculation. The more cutting done in the perineum, the greater the risk of nerve damage. Problems with achieving an erection occurs in a small percentage of men and it is often temporary. It takes some time after surgery for the nerve damage to heal so that the erections can occur again. In cases of radical cancer surgery, permanent erectile difficulty may result. If the individual isn't willing to live without the ability to achieve an erection there are two options available:
WOMEN: In the female, ostomy surgery doesn't affect sexual ability, conception, or pregnancy and she can have a happy healthy baby. The main problems for females after ostomy surgery is painful intercourse. This is thought to be due to the absence of the rectum to cushion the vagina during intercourse. It can also be attributed to stenosis and scarring of the vagina after radical cystectomy. Damage to the autonomic nervous system can result in decreased vaginal lubrication.
During pregnancy, the size and shape of the stoma changes as the abdomen changes in size. This may require a visit to your ET nurse and a change in your pouching system. Otherwise it is "business as usual" with the management of the ostomy during pregnancy.
One question facing many ostomates post- operatively is "when is it safe to resume sexual relations?" It is best to discuss this with your surgeon. It's safe to say that when the incisions are well healed and your strength returns to normal it is time to resume sexual activity. Trying too soon after surgery can result in failure due to fatigue - not mention the blow to your ego!
