Medically reviewed. Andrea Apolo
After that bladder cancer In treatment, a woman is often left struggling. She looks at her new body in the mirror, maybe urostomy bag She is hooked and worried that she is no longer sexy and that her sex life will never be the same.
But there is hope for him – and all bladder cancer patients. A healthy, satisfying sex life is possible after bladder cancer treatment.
Stages and treatment
Non-muscle invasive bladder cancer (NMIBC) It occurs in the bladder lining and is the most common stage of bladder cancer in the United States. NMIBC treatment usually involves scraping the tumor from the bladder wall and, in some cases, placing the drug directly into the bladder. In rare cases, the bladder may need to be removed. cystectomy. D., a urological oncologist at Johns Hopkins Medicine in Baltimore. “We can remove the patient’s bladder if the type of tumor is an extremely aggressive subtype or if conservative approaches fail,” Armine Smith said in an email.
advanced bladder cancer, muscle-invasive bladder cancer (MIBC)Occurs when cancer has spread to the muscles of the bladder wall. The traditional treatment for MIBC is a radical cystectomy, which is the removal of nearby organs, including the bladder and uterus, fallopian tubes, ovaries, and part of the vagina, following chemotherapy. After surgery, doctors create a new pathway for urine to leave the body. This is a stoma – an opening in the abdomen. A patient may also have a urostomy bag – a pouch that collects urine outside of the body.
a new body
With both NMIBC and MIBC, patients may experience bodily changes that affect their sex life. “Any type of bladder treatment … can affect urinary function and cause pelvic pain, which can affect a woman’s sex life,” Smith wrote. “These changes can be temporary or permanent.” Patients can also side effects vaginal dryness, decreased sex drive and fear of contaminating partners with drugs and having a radical cystectomy will all lead to menopause if the woman is not postmenopausal.
“Removing the genitals can cause menopausal symptoms because you’re removing organs that produce hormones that help with many sexual functions, such as lubrication,” she said. Andrea ApoloD., a medical oncologist at the National Cancer Institute in Bethesda, Maryland. Women with this lack of natural lubrication can use store-bought lubricants or vaginal hormones when it is possible.
“We want to make the vagina feel happy again after such an operation. “Vaginal hormones can help the vagina feel more flexible and tight,” she said. Doctor Heather Bartosan OB-GYN and HealthyWomen’s member Women’s Health Advisory Council.
A radical cystectomy can shorten the vagina, causing painful intercourse and penetration. Solutions include: vaginal dilators — plastic, cone-shaped objects used to stretch the vagina — and vaginal reconstructiona surgical procedure that lengthens the vagina.
pelvic exercises, for example barrelsIt may also help after cystectomy. Working with a physical therapist can also help. “A pelvic floor physiotherapist it can help relieve muscle tension there and release any scar tissue,” Bartos said.
nerve damage It can also occur during cystectomy. Nerve bundles inside the vagina may be damaged and the clitoris may lose sensitivity if the tip of the urethra is removed. Patients should talk to their doctor about preserving these areas before surgery.
“Whenever there is cancer in the pelvic organs and a woman has to have all these organs removed, there is a lot of emotional trauma,” Bartos said. Apolo explained this as patients’ need to adapt to what he calls a “new state of being.” According to Smith, women face many problems when diagnosed with bladder cancer. These problems can include depression and anxiety, which can turn into decreased sexual desire or satisfaction. Some of these problems may be due to the emotional burden of diagnosis or treatment, while others may be due to physical changes resulting from treatment.
Addressing the emotional consequences of bladder cancer is probably a mental health specialistIt is important for sexual health. “In either case, talking to a therapist [or] “couple therapy or both can really help get those feelings out,” Bartos said.
Many women also experience a lack of confidence about their bodies after a cystectomy. “Patients with an external device may feel embarrassed and worried that their partner will not find them attractive,” Apolo said. Intimacy suits are available for women with stomata and can make them feel sexier. But Apolo believes the most important way to feel comfortable after surgery is to speak openly with doctors, partners and other patients. There are communities on the Internet, for example Bladder Cancer Advocacy Networkwhere patients support each other and share knowledge.
“Writing stories like this is important. I think the best way to empower people is with information and resources, because bladder cancer can feel very lonely after being diagnosed,” Apolo said.
find a way to enjoy
For most patients, the clitoris is not affected by the surgery and clitoral orgasm is still possible. However, even in patients who have lost their clitoral sensitivity or struggle with the vaginal intercuses, orgasm and pleasure is still within reach.
“Having this surgery does not mean the end of sexual life. “There’s a lot women can do to maintain a healthy sex life,” Apolo said. She explained that the most important part of this is communicating with your partner about what feels good and what doesn’t.
Bartos noted that sexual pleasure after cystectomy may look different than before. “There is still so much pleasure to be experienced. If vaginal intercourse is uncomfortable, some patients may try anal or oral sex. It’s about what works for that woman. “It just might not be the way he always assumed sex was,” she said.
Bartos said that single women may find it easier to enjoy after bladder cancer compared to those in loyal relationships. “Single women move faster in their new sexuality because they can enjoy themselves without the pressure to please another person or the feelings of self-confidence that comes from having a partner see them,” she wrote in an email.
Sure, a caring partner can be a great source of support, but Apolo discovers that a woman’s personality plays a more important role than her relationship status. “It really depends on the person and how sexually active they were before the surgery,” she said.
One of the best ways to face bladder cancer and its impact is to be prepared. Women should talk openly with their urologist, oncologist, and gynecologist about what to expect after surgery. “If you’re a little prepared for it to be a different way of life, you’ll be more prepared for the outcome after treatment,” Apolo said.
Another important issue that patients may want to discuss with their doctor is having children. Although most women diagnosed with bladder cancer are over the age of 55, it is still possible for women of childbearing age to develop the disease. Because treatment may require genital removal, younger women may want to discuss reproductive options, such as freezing their eggs, with their doctor before treatment begins.
People with bladder cancer should also ask their doctor about alternative treatment options, such as radiation and chemotherapy. Aggressive surgery is currently the most accepted treatment for MIBC, but other options are being explored and for some patients, chemoradiotherapy may be an option. Doctors are also turning to surgical methods that preserve the genitals and nerves necessary for sexual pleasure. According to Smith, the Johns Hopkins Women’s Bladder Cancer program has moved away from routine removal of pelvic organs during cystectomy and advocates procedures that leave organs and nerves in place that can reduce sexual problems.
Sex may not look the same after treatment. Pleasure may come from a new place and a woman’s body may feel different than before. But none of this means she can’t enjoy sex after her bladder cancer. She can find her way back to a full, satisfying sex life.
This resource was created with the joint support of Astellas and Seagen.