Your sex life after pelvic exenteration

The physical changes to your body after the operation (surgery) can mean changes to your sex life. The operation varies from person to person. How it affects you physically and emotionally will also vary. You may need to make some adjustments.

Your surgeon and specialist nurse will talk to you about the changes you may have. It can help to talk about any questions or worries you have. You may find it difficult to talk about your concerns with your doctors or nurses. But they are used to talking about these issues. They can give you advice and answer your questions.

You may not feel like having sex for a while. If you have a partner, you may both need time to get used to any changes. There are different ways you can show your partner you care about them. This can include spending time together and showing affection through touching, holding hands or putting an arm around their shoulder. You may also find new ways to share sexual pleasure.

After treatment, you may find that your sex life slowly improves. If you continue to have difficulties, ask your specialist nurse or doctor for advice. They can refer you for more specialised support if needed.

Although the vagina is often removed during pelvic exenteration, the clitoris usually remains. This means you may still have pleasure or orgasms from this area.

If you have had vaginal reconstruction, vaginal sex may be possible once you have healed. But you may need to try different positions to find what feels most comfortable for you. Your new vagina will not make its own lubrication. You will need to use lubricant gels during sex. Your specialist nurse can give you more information about this and give you advice on coping with any difficulties you may have.

If you have had a posterior or total exenteration, anal sex will be affected. These operations remove the rectum, and sometimes the anus. If the anus has not been removed, your surgeon may still advise you to avoid anal sex. The area may be more delicate after surgery. It is important to talk to your surgeon or specialist nurse before having anal sex.

Coping with changes

Adjusting to changes in how your body looks and works takes time. If you have a partner, you may feel nervous about how they will react to the changes. Or if you are single, you may feel nervous about starting a new relationship. Many people need to talk through their feelings and emotions. There is no right or wrong time or way to talk about these things. You can wait until you feel ready.

If you have a partner, it may take time for them to accept and adjust to changes in your body. They may find it helps to talk about how they are feeling. Your doctor or nurse can tell you what help is available. You could see a sex therapist or counsellor as a couple. Your GP, specialist nurse or surgeon can refer you.

There are also organisations that can give you information, advice and support about sex and relationships. The College of Sexual and Relationship Therapists (COSRT) has a list of nationwide counsellors and therapists who can offer advice and support.

Before my operation I thought “this is the last time I’m going to look the same”. Things were going to be different. But there’s no point being negative.

Stella

Fertility

As part of pelvic exenteration, your surgeon will remove your reproductive organs. This means that you will not be able become pregnant or have children. If you have not been through the menopause, it will start after pelvic exenteration. Your doctor or a menopause specialist should support you. They will talk to you about how to manage menopausal symptoms.

It can be upsetting to hear that you will no longer be able to have children. You may find it helpful to talk with a partner, family member or friend. Or you might prefer to talk to a trained counsellor. Your GP or cancer specialist can arrange this for you. Many hospitals also have specialist nurses who can offer support. Fertility clinics also usually have a counsellor you can talk to.

You can ask to be referred to a fertility specialist before having cancer treatment. You may be able to store your eggs or embryos (fertilised eggs) and use a surrogate in the future. This means that another woman will carry the child in her womb for you. Or you may want to consider adoption in the future.

It is important to talk to your cancer doctor, surgeon or specialist nurse about fertility before starting treatment. Think about the questions you want to ask. This will help you can get all the information you need. If you have a partner it is usually a good idea to include them too.

Talking to others in a similar situation may help you feel less alone. Some organisations can arrange this for you and provide specialist advice and counselling. Or you can talk to people online. Our Online Community is a good place to talk to others who may be in a similar situation.

You can also talk things to one of our cancer support specialists.

Stomas

Many people have concerns about sex when they first have a stoma. Sex will not affect the stoma. But it can make some sexual positions uncomfortable. It can also affect the way you feel about your body. To reduce discomfort, it can help to choose positions that keep your partner’s weight off the stoma.

Make sure the bag fits well and does not leak. It is a good idea to empty the bag before having sex. Some foods can cause the bag to fill quickly, so sometimes you might choose to avoid eating or drinking anything that usually causes you problems. You may be able to plug the stoma or wash it out, so that a bag is not needed for a short time. This is not suitable for everyone. Your stoma nurse can give you advice on this.

Your stoma nurse can give you advice and support. Stoma support organisations like Colostomy UK, the Urostomy Association and the Ileostomy and Internal Pouch Association also have information you may find helpful.

Back to Pelvic exenteration in women

Having pelvic exenteration

Pelvic exenteration takes about 8 hours – after the surgery, urine (pee) and stools (poo) will leave your body in a new way.