Special Sexual Concerns with Cancer

Urostomy, colostomy, or ileostomy

An ostomy is a surgical opening created to help with a body function. A urostomy takes urine through a new passage and sends it out through an opening on the belly (abdomen) called a stoma. A colostomy and ileostomy are both openings on the abdomen for getting rid of body waste (stool) from the intestines or bowels. In an ileostomy, the opening is made with the part of the small intestine called the ileum. A colostomy is made with a part of the colon (the large intestine).

You can reduce the effect these ostomies have on your sex life if you take some common-sense steps. First, make sure your appliance (pouch system) fits well. Check the seal and empty your ostomy bag before sex. This will reduce the chance of a major leak. If it does leak, be ready to jump into the shower with your partner and then try again.

A nice pouch cover can make an appliance look less “medical.” You can get covers or patterns to make your own from your enterostomal therapist or ostomy supply dealer.

Another choice is to wear a special small-sized ostomy pouch during sex. Or if you have a 2-piece system, turn the pouch on the faceplate so the emptying valve is to the side. If you wear an elastic support belt on your faceplate, tuck the empty pouch into the belt during sex. You can also wear a wide sash around your waist to keep the pouch out of the way. Another way of keeping the pouch from flapping is to tape it to your body. Some men feel more comfortable wearing T-shirts to cover their appliances.

To reduce rubbing against the appliance, choose positions for sex that keep your partner’s weight off the ostomy. If you have an ostomy but like to be on the bottom during sex, try putting a small pillow above your ostomy faceplate. Then, your partner can lie on the pillow rather than on the appliance.

Laryngectomy

Laryngectomy is surgery that removes the voice box. It leaves you unable to talk the normal way, and you breathe through a stoma (opening or hole) in your neck. Since the air you breathe can’t be purified by the nose’s natural filter, a special type of stoma cover is needed. Besides catching dust and particles, the stoma cover hides the mucus that leaks out of the stoma. A scarf, ascot tie, or turtleneck can look nice and hide the stoma cover. Even during sex, a cover may look more appealing than a bare stoma.

During sex, a partner may at first be startled by breath that hits at a strange spot. On the positive side, one patient quipped, “Now when I kiss, I never have to come up for air!”

You can lessen odors from the stoma by avoiding garlic or spicy foods and by wearing cologne or after-shave lotion.

Sometimes problems in speaking interfere with communication between couples. If you have learned to speak using your esophagus, talking during sex is not a big problem. But it does take more effort, and you lose some of the emotional nuances. A speech aid built into the stoma might also work well. But neither method lets you whisper in your partner’s ear. If you use a hand-held speech aid, communication during sex is likely to be awkward and distracting. Still, you can say a great deal without words by guiding your partner’s hand or using body language.

Talking is not needed in many sexual situations. But with a new partner, you may want to talk about the kinds of touching and positions you like before you start making love.