A: Reclaiming your sexuality is an important part of your recovery. The best way for you to reduce your anxieties and those of your partner is to become better informed about your sexual functioning after ostomy surgery. Sexual ability may or may not be limited following ostomy surgery. This often depends on the extent of the surgery and the degree of nerve damage. Also, radiation treatments to the pelvic area may limit sexual function. Your surgeon will discuss these issues with you. When sexual function is altered, men may have impotence, the inability to achieve or maintain an erection. Men may also have retrograde ejaculation or "dry" orgasm. Women may have painful intercourse because of the scar tissue constricting the vagina. Lack of lubrication may also be a problem.
Altered sexual function does not destroy sexuality. Intimacy can become the objective of sexual activity rather than intercourse. Hugs, kisses, cuddling, caresses, petting, touching and massage can be a way of showing and receiving affection and redefining sexual activity.
During sexual activity, the stoma can be covered with a specially designed stoma cap. As an alternative, the appliance can be concealed with a pouch cover. It is advisable to empty the pouch prior to sexual activity and check that the appliance is secure. Eating at regular times and avoiding gas-forming foods will decrease the chance of flatus. Using perfumes or deodorants will enhance perceptions of desirability. Experiment with different positions to prevent interference from the appliance and remember that humor lessens any embarrassment. Most important of all, talk about your feelings and emotions with your partner.
Sexuality is like anything else in life; if it is worthwhile, it requires preparation and work. Contact your ET nurse for information on pouch caps and covers.