Login
Register

Home

About Us

Diagnoses

Treatments

Classes

Resources

Media

Testimonials

Blog

Account

Blog
Register

If you’re facing a diagnosis of bladder cancer or a similar health concern, sex may be the last thing on your mind.

However, your sex life after a cystectomy (bladder removal surgery) should be a major consideration for any doctor who recommends it.

Sadly, research shows that’s much more likely to be true for men than it is for women. In fact – although sexual function after bladder removal is ‘routinely considered’ for male patients – surgeons in one study discussed complications that could affect pelvic health and sexual function with just 13% of female patients. Worse, the medical counseling those women got after surgery ignored the topic of sex altogether.

A group of urologists from Wake Forest Baptist Medical Center in North Carolina is fighting to close that gender gap. Their recommendations – based on a review of more than 70 sources of scientific data – were recently published in the Sexual Medicine Reviews.

One of their findings is cause for celebration; survival rates after a cystectomy are rising. But women who beat the odds still discover that, when it comes to post-surgical quality of life, sex can be difficult and painful for a number of reasons (medically termed dyspareunia). Pelvic Organ Prolapse is a common complication; and a radical cystectomy often involves a section of the vagina. Ovaries may also be removed, leading to a sudden loss of estrogen. The bladder removal itself requires a medical decision about the best way to permanently divert the flow of urine.

Needless to say, cystectomy has a profound effect on a woman’s sex life. Patient complaints range from problems with lubrication and orgasm to painful sex. Across various studies, 30-60% of female patients report a decrease in sexual satisfaction after surgery; and many of them stop having sex altogether.

With the right intervention, it’s possible for women and their partners to adjust and return to a pleasurable sex life. But the researchers say that intervention should start before surgery, with doctors prioritizing sexual satisfaction equally for men and women as part of the bigger picture of post-surgical quality of life.

If your doctor has recommended a cystectomy, make sure the surgical checklist includes these three important things:

Pre-surgical discussion of all the risks and side effects. You need to know what you’re facing, and your doctor needs to know your goals for sexual function before you decide together on the best treatment plan.

Full consideration of alternative surgeries. In some cases, robotic surgery or a simple cystectomy may be just as effective as a radical cystectomy while significantly lowering the risk of complications.

Comprehensive follow up, including evaluation and treatment of sexual or urinary complications that affect quality of life. That may include pelvic floor physical therapy.

Every cystectomy case is different; and the best chance of survival is always the top priority. But there is more to life than survival; make sure your medical team supports your entire quality of life, including your sex life.

References:

Citation – Voight M., Hemal K., Matthews C. 2019. Influence of Simple and Radical Cystectomy on Sexual Function and Pelvic Organ Prolapse in Female Patients: A Scoping Review of the Literature. Sexual Medicine Reviews 7:3 408-15.

What Our Patients Have to Say

Prev
Next

Testimonial by Fritzette H.

I went to Heather after the birth of my third child. It was lucky, really, that I was referred to her, because my doctor had referred me to a surgeon for a possible hysterectomy or pelvic wall rebuild. Thankfully, I went to Heather before undergoing either surgery, she was able to fix the problem. She has studied extensively in women's health--even written a book about it--and was able to diagnose my problem, suggest a course of treatment (6 weeks), and then follow through with said treatment. By the end, as she said, I was as good as gold. Boy, was it worth it! Though uncomfortable to talk about, much less write about, it is worth getting the word out there. If you have painful intercourse, especially after birth or other trauma, the treatment may be as simple as Physical Therapy (with Heather, of course). I highly recommend her.

-- Fritzette H., 3/24/16 via Yelp!

Testimonial by M.M.

A personal journey and testimonial from one of my patients:

My husband and I were married for 5 years before we were able to have intercourse due to my vaginismus. There was nothing traumatic in my past but for some reason, even though I wanted sex, I mentally avoided "that area" of my body and didn't even admit to myself that there was a problem for a long time, even though I was never able to put tampons in. Once I finally opened my eyes up to the fact that I had a problem, I had a surgery that was supposed to fix the issue.

Read more: Testimonial by M.M.

Testimonial by M.M.

A personal journey and testimonial from one of my patients:

My husband and I were married for 5 years before we were able to have intercourse due to my vaginismus. There was nothing traumatic in my past but for some reason, even though I wanted sex, I mentally avoided "that area" of my body and didn't even admit to myself that there was a problem for a long time, even though I was never able to put tampons in. Once I finally opened my eyes up to the fact that I had a problem, I had a surgery that was supposed to fix the issue.

Read more: Testimonial by M.M.

Testimonial by P.M.

I was hopeful but frankly skeptical when the doctor treating me for Interstitial Cystitis recommended that I go to Heather for physical therapy. Medication and diet helped control my IC symptoms, but I had never heard of physical therapy being used to treat IC. The education and treatment I received from Heather was a revelation. She explained that the pain I experienced with IC had helped create a cycle of muscle guarding which affected the entire pelvic area. I had no idea of the amount of tension being held there. No wonder my husband and I had not been able to have sexual intercourse for years!

Read more: Testimonial by P.M.

Testimonial by Lauren B.

Femina PT (née Fusion Wellness & Physical Therapy) has been such an answer to prayer, i'm so glad I found them! I've been struggling with vaginismus my whole life, but didn't have a name for it until about 6 or 7 months ago. Even once I did have a name for it though, I didn't know where to begin in getting help. My OB/GYN had me get a set of dilators, but I couldn't even insert the smallest one by myself. Most times I tried I just ended up frustrated and in tears. I felt really alone, like I was broken and didn't have the energy to keep trying. When I got engaged a few months ago though, I realized I needed to get answers so i wasn't dreading my honeymoon.

Read more: Testimonial by Lauren B.

Testimonial by M.M.

A personal journey and testimonial from one of my patients:

My husband and I were married for 5 years before we were able to have intercourse due to my vaginismus. There was nothing traumatic in my past but for some reason, even though I wanted sex, I mentally avoided "that area" of my body and didn't even admit to myself that there was a problem for a long time, even though I was never able to put tampons in. Once I finally opened my eyes up to the fact that I had a problem, I had a surgery that was supposed to fix the issue.

Read more: Testimonial by M.M.

Subscribe To Our Newsletter

Get access to our free downloads and a 15% discount on Heather's book "Sex Without Pain"!
captcha 
I agree with the Terms and Conditions and the Privacy policy