Sexuality

Resuming sexual relations after surgery can be an anxious time. What do you do with the bag? What if your partner finds it offensive? How do you tell a prospective partner about the ostomy? Can you have sex at all? The answer to the last question is yes, of course.

Women with an ostomy have no physical impediment to intercourse, although stenosis (narrowing) of the vaginal canal is a common side effect if your surgery required removal of the anal sphincter. If the anus has been removed, intercourse may be uncomfortable or painful. Generous use of lubricant is key, as is a gentle partner. Stenosis usually eases over time.

Men may face more challenges. Erectile dysfunction is more common after urostomy surgery than ileostomy or colostomy surgery. How long this lasts will vary depending on the type of surgery, how invasive it was & possible nerve damage; age at time of surgery; and general health condition. Returning to sexual relations may happen after a few weeks, or it may take months. It’s alright to masturbate if you want, so long as you aren’t experiencing any pain while doing so. If you have healed well and are otherwise in good recovering health after six months and are still not happy with your sexual performance, you should see your doctor. Impotence can happen to any man, not just those with an ostomy. Treatment prescribed usually consists of medications such as Viagra, Cialis or Livitra. In all cases, dosage, method, and possible side effects must be thoroughly discussed with your doctor.

It goes without saying that you should empty your appliance before intimacy and take care that you are clean and have no odour. Folding the bag up and taping it to your abdomen can get it out of the way and stop it from distracting you. (any more than you’re already distracted, that is.) If you are feeling self-conscious sometimes camisoles or ‘adult’ lingerie can make things more discreet for the ladies. Men may keep a T-shirt on so the appliance is less obvious. The plastic in some appliances can rustle in an annoying manner — those with fabric covering are quieter. It’s a good idea to have some tissue, or a towel nearby in case of surprises. Some ostomy manufacturers make appliances that can be used during intimacy — stoma caps or mini-bags. These are much smaller than a standard pouch and very discreet.

When and how you choose to resume sexual relations is a very personal decision; above all remember that communication with your spouse or partner is essential. Talk about intimacy in advance and try not to put too much pressure on each other to do everything you did before right away. Remember that your spouse or partner may be as nervous and self-conscious as you are! Whatever your previous sexual habits were before, you should be able to return to these activities if you choose — just bear in mind that the stoma should be unrestricted during intimacy and must NOT have anything inserted in it. You may wish to discuss any concerns about the safety of sexual practices with your doctor, NSWOC or counsellors in the field of sexuality. Other ostomates can be a good resource as well, for they may share similar concerns and be willing to have a personal discussion.
Source: A Handbook for New Ostomy Patients. Used with permission from Debra Rooney, Vancouver Ostomy Chapter.
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