Sexuality & bladder cancer

Tuesday 31 July, 2007

Reviewed by: Assoc. Prof. Jeremy Millar, Alfred Hospital, William Buckland Radiotherapy Centre

On this page: Damage to the nerves of the penis | Changes to the vagina | Talking about sexual problems

Cancer treatment and the emotional effects of cancer may affect people with cancer and their partners in different ways.

Some people may withdraw through feelings of being unable to cope with the effects of treatment on themselves or their partner. Others may feel an increased need for sexual and intimate contact for reassurance.

It is important to talk about your feelings with your partner. If you have trouble continuing with your usual sexual activities, discuss this with your doctor or with a trained counsellor.

Some people can feel sad about going through a cancer diagnosis and treatment without a partner. Sharing these feelings with a counsellor or a trusted friend or family member can make a big difference to how you feel.

Damage to the nerves in the penis

Apart from the emotional changes, removal of the bladder (cystectomy) may cause problems with sex. It is often impossible to avoid damage to the nerves in the penis during the operation, although your doctor will do all they can to prevent nerve damage. Nerve damage can make it difficult for a man to get an erection. Radiotherapy can also mean poorer quality erections.

There is treatment for men who have problems getting erections. Oral medications such as Viagra or injections into the penis may help with sexual functioning. External vacuum devices may be used to produce erections. They are simple, painless and easy to use, and are available from sex aid shops or on prescription. There are also implantable mechanical devices called penile prostheses, which consist of flexible rods or thin inflatable cylinders inserted surgically into the penis. Talk to your doctor or nurse or a trained counsellor if you need more information.

Changes to the vagina

In some women, the vagina (birth canal) may be shortened or narrowed during the operation to remove the bladder, although the doctor will take care to leave as much of the vagina intact as possible.

This can make penetrative sex difficult or uncomfortable at first. One of the best ways of overcoming this problem is to start having sex regularly and gently, as soon as you feel ready. This will gradually stretch the vagina, making it more supple, and will make sex easier and more enjoyable.

If your uterus has been removed, it can make a woman feel she has lost a part of you female identity. Talking to your doctor about any problems will help to bring fears and worries into the open. If you wish, they can refer you to a specialist in sexual problems, or a trained counsellor, for advice and support.

Talking about sexual problems

You may find it difficult or embarrassing to talk about sexual problems. However, most doctors are very understanding, and even if they're unable to help they can refer you to a doctor or therapist who specialises in sexual problems. These specialists can offer emotional support and advice on how to cope with sexual difficulties and related problems. It can be helpful to remember that they deal with situations like this every day and are used to discussing personal problems. If you have a partner, it may be helpful for them to see the specialist with you so that any fears and worries can be brought out into the open. 

See our Sexuality and cancer section for more.

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