Many bladder cancer patients remain interested in sex after having bladder removal surgery, according to the authors of a recent Journal of Sexual Medicine study.
This type of bladder surgery is called a radical cystectomy. In men, it involves the removal of the bladder itself along with the prostate gland and seminal vesicles (glands that produce substances found in semen). For women, radical cystectomy usually includes the bladder, ovaries, fallopian tubes, uterus, part of the cervix, and part of the vagina.
Once the bladder is removed, surgeons create a new way for urine to leave the body. Sometimes, urine is diverted to a special pouch worn outside the body. In other cases, surgeons might create a neobladder inside the body, which allows a person to urinate normally.
Because radical cystectomy involves organs and nerves that are important for sexual function, sexual issues are common after surgery, such as erectile dysfunction (ED) in men. However, few medical studies have focused specifically on sexual function after radical cystectomy.
For this study, scientists surveyed 132 bladder cancer patients (109 men and 23 women) who were undergoing radical cystectomy at one hospital between 2016 and 2019. The participants’ average age was 69 years. They answered questions about their experiences with bladder cancer, treatment, and sexual function.
About 53% said that they were “at least a little” interested in having sex, and about 40% had engaged in sexual activity during the previous four weeks.
However, women tended to have worse sexual function than men did, according to validated questionnaire scores. Older men and women also had more sexual difficulties. In addition, 40% of the sexually active patients were concerned that sex would contaminate their partner.
Patients with neobladders seemed to be more interested in sex, but had “slightly worse” scores on sexual function assessments.
Noting that more than half of the patients had sexual interests, the authors stressed the importance of sexual counseling for bladder cancer patients.
“Given the recent increase in attention given to [sexual function] outcomes and quality of life, this work supports further efforts to explore this area and develop novel interventions to improve outcomes,” they wrote.
They acknowledged that their study had a low number of female participants and that data were collected from just one medical institution, which limited their findings. They encouraged further research in this area.
The Journal of Sexual Medicine
Westerman, Mary, E., MD, et al.
“Radical Cystectomy and Perioperative Sexual Function: A Cross-Sectional Analysis”
(Full-text. Published: July 23, 2020)
Black, Peter, MD, FACS, FRCSC and Wassim Kassouf, MD, CM, FRCS
“Patient education: Bladder cancer treatment; invasive cancer (Beyond the Basics)”
(Topic last updated: May 19, 2020)