Cystectomy (bladder removal) and Female Sexual Functioning (The James)

Cystectomy (bladder removal) and Female Sexual Functioning (The James)

 

A cystectomy is a surgery to remove the bladder. The surgeon may also remove the uterus, ovaries, fallopian tubes, cervix, front wall of the vagina, and the urethra. Talk to your surgeon about the specific details of your surgery. This surgery may affect a woman’s sex life, but sometimes things can be done during surgery to help preserve female sexual function.

 

Changes in the vagina after cystectomy

Cystectomy often removes half of the vagina, but penetration is still possible. The vagina may be shortened during your surgery. There may also be an option to have vaginal reconstruction done based on your situation.

If your vagina is shortened, you may still enjoy sexual activity. Certain positions like those where the partners are side by side or with you on top, limit the depth of penetration. There are also rings that can be put around the base of the penis to reduce the depth of penetration. If vaginal penetration remains painful, a couple can still reach orgasm by touching each other with their hands.

 

Orgasm after cystectomy

Many women who have had the front wall of the vagina removed as part of a cystectomy say that this has little or no effect on their orgasms. But others say that they were less able to have orgasms. There are 2 nerve bundles that run along each side of the vagina, these can be damaged when removing the front of the vagina. Talk with your doctor about your planned surgery and whether these nerves can be “spared” (left in place) during surgery. If so, this can help increase your chance of having orgasms after surgery.

If the urethra is removed (where urine exits the body), the clitoris may lose blood supply. This may affect some parts of sexual arousal. (Remember that, like the penis, the clitoris fills with blood when a women is excited or aroused). Talk with your surgeon about whether the end of the urethra can be spared, and how that may affect your clitoral function. It’s not always necessary to remove the end of the urethra as part of surgery for bladder cancer.

At The James, there are supportive services for those interested in talking to a sex therapist. A sex therapist is a licensed mental health professional trained to provide counseling to those with sexual issues and concerns. Your expectations regarding sex may change after your cystectomy surgery. A sex therapist can help you understand and cope with the changes to your body.

 

Adapted from www.cancer.org. Used with permission from the American Cancer Society. All rights reserved.

 

 

© March 31, 2022. The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute.

This handout is for informational purposes only. Talk with your doctor or health care team if you have any questions about your care.