Bladder Cancer & Sexual Health

Hello. My name is Dr. Nick Myers and I am a new contributor to BladderCancer.net. I’ve been writing for a few months on the ProstateCancer.net site and I hope I can offer meaningful insight to claiming and reclaiming your sexuality while you are fighting Bladder Cancer. For me, two issues are of the utmost importance. First, I believe ones quality of life should be an important consideration when fighting Bladder Cancer. While doctors and surgeons are saving your life, I feel it is important for your treatment team to consider and inform you what your life will look like after-cancer. Secondly, I am also concerned about your sexual health. So, as people comment on my articles, I’d like to continue the conversation by looking for solutions to sexual problems so, you can be sexually healthy and enjoy your sexuality. Lets begin.

Getting started

Generally speaking, almost any issue in the pelvic area can lead to sexual dysfunction. With prostate cancer (PC) and bladder cancer (BC) constantly ranking in the top-5 reported cancers, sexual health problems for both men and women are common.

Typically, BC starts on the surface and becomes “invasive” when it has entered the wall of the bladder. When the cancer becomes invasive, treatments may include chemotherapy and/or radiation therapy, both of which can cause a great deal of damage to your body, and in the end, your sexual health. These treatments can leave you feeling sick, exhausted and definitely not in the mood for any sex play. Let take a quick look at some of the effects surgery for BC can have on your sex life.

Sexual issues caused by surgical treatments

Women

I’d like to start by saying there really isn’t too much information on sexual health issues and BC for women. The research mentions nerve damage and partial removal of the vaginal canal caused by radical cystectomy. Surgeons are now working to preserve the clitoral nerves and the vaginal canal to aid in lubrication and vaginal depth for pain-free intercourse.¹

Some authors went on to mention sexual attractiveness after radical cystectomy and bladder reconstructive surgery. Bjerre et al. found that one-third of women described physical problems or decreased desire and 30% felt less sexually attractive after cystectomy.²

Men

Using the nerve-sparing technique works well for men. Using this technique to save the vas deferens, seminal vesicles and nerves seems to work well, with 95% of men reporting erections during follow-up visits 68-months post treatment.³ Other researchers are reporting ‘good potency preservation’ using a prostate-saving technique, but they also mention erectile function is related to the location of cancer and removal of the prostate gland.⁴ Also, I’d like to see research on the feelings on sexual attractiveness and sexual desire in men after a radical cystectomy as well.

Speak up

As I close this article, I’d like to advocate for a full-team approach, that includes a sexual counselor or sexual therapist. Please talk to a sexual therapist regarding issues you are experiencing. While you can speak to a therapist alone, I recommend including your partner in these discussions so everyone has the opportunity say how they feel so you both can move forward together.

Faith and motivation

I’d like to add one point. There may be those of you who have given up on being sexual ever again. I have to say this…while your sex life may not be what it used to be, you have the right to be sexual and enjoy your sexuality. Never give up on yourself and your potential to be sexual. You must be honest with yourself and have open conversations with partner, husband/ wife and lovers.

You are not alone and you should not feel ashamed if you are experiencing sexual health issues. To me, it goes back to quality of life. Yes, you should enjoy your sexuality so don't suffer in silence. If you have questions or need help, reach out to a professional for help.