Sex and fertility after bladder surgery

After surgery for bladder cancer, you may have changes to your body that affect your sex life. For some men, nerve damage may mean that you have problems getting or maintaining an erection. There are different ways to help erection problems, including using tablets, pellets, injections or vacuum pumps. Your surgeon or specialist nurse can talk to you about what might work best for you. 

For some women, the vagina can be shorter or narrower after surgery. When you feel ready, having regular, gentle sex can help. Your doctor or nurse may suggest using vaginal dilators. They may also suggest gels or creams to help with any discomfort. Some women find they have different sensations during sex.

It can be difficult to talk about sexual problems. If needed, your doctors can refer you to a specialist in sexual problems.

It’s safe for you to have sex as soon as you feel ready. Cancer can’t be passed on during sex.

Depending on the type of surgery you had, you may have fertility problems. Your surgeon will speak to you about this before surgery.

Sex after surgery

Your operation may have made changes to your body that can affect your sex life. Your surgeon and specialist nurse will talk this over with you before your surgery. They can tell you about things that may help.

Your doctors will do all they can to prevent nerve damage during the operation, but it may not be possible to avoid it. If nerves are damaged, there’s a risk of erectile problems in men and changed sensation in women.

Men

There are different treatment options for men with erectile difficulties after surgery. Your surgeon or GP will be able to advise you on these.

Treatment may involve tablets, such as sildenafil (Viagra®), vardenafil (Levitra®) and tadalafil (Cialis®) to produce an erection, if the nerves are not damaged. They can’t be taken by men who take nitrate-based medicines for heart problems. Your doctor can advise you about this.

Pellets put into the tip of the urethra or injections given into the penis with a small needle can also help to produce an erection.

Vacuum pumps may also be used to give an erection lasting for about 30 minutes. You put your penis into the pump. It has a handle that draws blood into the penis by creating a vacuum. You then put a rubber ring around the base of the penis. It traps the blood in the penis to give an erection. You take the ring off after sex and the blood flows normally again. Pumps may take a bit of practice before you get used to them.

Talk to your surgeon or specialist nurse about what might be best for you. They will be able to explain about the different treatments in more detail. Your surgeon may suggest using a combination of tablets and a vacuum pump soon after surgery.

The organisations listed on our databaase can give you advice and information about sexual difficulties. Our information for men about sexuality and cancer has more information on treatments for erection difficulties.

Women

In some women, the vagina may have been shortened or narrowed during the operation. This can make sex difficult or uncomfortable at first. When you feel ready, having sex regularly and gently can help gradually stretch the vagina. This makes it more supple, which means sex will be easier and more enjoyable.

You may be advised to use a vaginal dilator. Your nurse or doctor can show you these and explain how to use them. Sometimes gels or creams that contain the female hormone oestrogen are prescribed to help ease discomfort in the vagina.

Some women find that they have different sensations during sex. It may be more difficult to have an orgasm. The organisations listed on our database can give you advice and information about sexual difficulties.

Talk to your surgeon or specialist nurse if you are worried or need advice about sex after your surgery. Our information for women about sexuality and cancer has more details. It gives tips for coping with various sexual problems caused by cancer treatments.


Talking about sex

You may find it difficult or embarrassing to talk about sexual problems. Most doctors are understanding and can refer you to a specialist in sexual problems, or to a trained counsellor. These specialists can give emotional support and advice about coping with sexual difficulties.

If you have a partner, it may be helpful for them to see the specialist with you. You can search on our database for some useful organisations you can contact.


Sex is safe

One common fear is that cancer can be passed on during sex. You can’t catch cancer by having sex. It is safe for you and your partner to have sex as soon as you feel ready.


Fertility after bladder surgery

A radical cystectomy will cause infertility in men. It will also cause infertility in pre-menopausal women, if their womb and ovaries are removed. If you have any worries about your fertility, talk to your surgeon before your treatment.

We have more information about cancer and fertility in men and fertility in women.

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