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  • Sexuality and intimacy after treatment for bladder cancer

    Last reviewed May 2012


    Changing body image

    Cancer treatment can change the way you feel about yourself (your self-esteem). You may feel less confident about who you are and what you can do. This is common whether your body has changed physically or not.

    Give yourself time to adapt to any changes. Try to see yourself as a whole person (body, mind and personality) instead of focusing only on the parts of you that have changed.

    Relationships with others

    The strong emotions you experience as a result of cancer may affect your relationships. The diagnosis and ongoing challenges may cause you to make some changes in your life or develop a new outlook on your values, priorities and life in general. Sharing those thoughts and feelings with your family, friends and colleagues may strengthen your relationships.

    If you feel uncomfortable talking about your feelings take your time and approach others when you are ready. People usually appreciate insight into how you are feeling and guidance on providing support during and after treatment. Calling Cancer Council 13 11 20 may help you build your confidence to discuss your feelings with others.

    While you are giving yourself time to adjust to the cancer diagnosis, do the same for friends and family. People may react in different ways – by putting on a happy face, playing down your anxiety or even ignoring you. They are also adjusting to changes.

    If someone’s behaviour upsets you it may help to discuss how you both feel about the situation.

    Sexuality, intimacy and cancer

    Having cancer can affect your sexuality in physical and emotional ways. The impact of these changes depends on many factors, such as treatment and side effects, the way you and your partner communicate, and your self-confidence. Knowing the potential challenges and addressing them will help you adjust.

    Surgery and other treatments to the pelvic area can cause sexual side effects. A person who has a urostomy bag may also feel embarrassed or upset which can affect their desire for sex.

    Sexual changes for men

    A cystectomy can often damage nerves to the penis but the surgeon will try to prevent or minimise this. Nerve damage can make it difficult for a man to get an erection. If the surgeon has to remove other organs such as the prostate or if you have radiotherapy, it can also cause poorer quality erections. However aids are available to help men who have erection problems.

    • Injections of medicine into the penis or oral medication can help blood to flow into the penis.
    • Vacuum devices that use suction may help produce erections.
    • If these methods are not successful getting an implant called a penile prosthesis may be an option.

    The treatment success will depend on your individual situation before and after surgery.

    Sexual changes for women

    In some women the vagina may be shortened or narrowed during a cystectomy although the doctor will try to leave as much of the vagina intact as possible.

    This can make penetrative sex difficult or uncomfortable at first. One of the best ways of overcoming this problem is to have sex regularly and gently, as soon as you feel ready. This will gradually stretch the vagina and will make sex easier and more enjoyable.

    Menopause and fertility

    Some women may have their uterus and other reproductive organs removed during a radical cystectomy. If you have not yet gone through menopause this will cause your periods to stop.

    It takes time for the body to adjust to changes in hormone levels. You may experience symptoms such as hot flushes and vaginal dryness. Your medical team can give advice about managing any symptoms.

    Menopause also means that it will no longer be possible to conceive children. You may feel upset and you may worry about the impact on your relationship. Even if you have finished having a family, it is natural to have mixed emotions. It may be helpful to talk about how you’re feeling with your partner, loved ones or a counsellor.

    Information reviewed by: Dr Paul Gassner, VMO Uro-oncological Surgeon at Bankstown, Liverpool and Shoalhaven Hospitals, NSW; David Connah, Cancer Council Connect Consumer Volunteer; Virginia Ip, Urology Care Coordinator, Sydney Cancer Centre, Royal Prince Alfred Hospital, NSW; Samantha Kelaher, Cancer Council Helpline Consultant, Cancer Council NSW; and Gary Schoer, Cancer Council Connect Consumer Volunteer.

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