A cystectomy can affect sexuality and fertility in many ways. You may find these changes upsetting and worry about how they’ll affect your relationships. Ask your treatment team for information about ways to manage these changes. It may be helpful to talk about how you’re feeling with your partner, family members or a counsellor.
For more on this, see Sexuality, intimacy and cancer and Fertility and cancer
Learn more about:
Changes for males
| nerve damage to the penis |
A cystectomy can often damage nerves to the penis, but the surgeon will try to prevent or minimise this. Nerve damage can make it difficult to get an erection. Options for improving erections include:
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| orgasm changes | You will not be able to ejaculate after a radical cystectomy if the prostate and seminal vesicles were removed along with the bladder. You can still feel the muscular spasms and pleasure of an orgasm even if you cannot ejaculate or get an erection, but it will be a dry orgasm because you no longer produce semen. |
| fertility changes | If the prostate and seminal vesicles are removed, you will no longer produce semen. This means you won’t be able to have children naturally. If you may want to have children in the future, talk to your treatment team about whether you can store sperm at a fertility clinic before treatment. The sperm could then be used when you are ready to start a family. |
Changes for females
| vaginal changes |
Sometimes, the vagina may be shortened or narrowed during a cystectomy. Nerves that help keep the vagina moist can also be affected, making the vagina dry. These changes can make penetrative sex difficult or uncomfortable at first. Ways to manage these changes include:
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| arousal changes |
A cystectomy can damage the nerves in the vagina or reduce the blood supply to the clitoris, which can affect how you become aroused and your ability to orgasm. Talk to your surgeon or nurse about ways to minimise potential side effects. You can also try exploring other areas of your body that feel pleasurable when touched, such as the breasts, inner thighs, feet or buttocks. |
| menopause and fertility |
Sometimes, the uterus and other reproductive organs are removed during a radical cystectomy. This will cause menopause if you have not already been through it. Your periods will stop, you will no longer be able to become pregnant, and you may have menopausal symptoms such as hot flushes and vaginal dryness. Talk to your doctors about ways to deal with the symptoms of menopause. |
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Prof Dickon Hayne, Professor of Urology, UWA Medical School, The University of Western Australia, Chair of the Bladder, Urothelial and Penile Cancer Subcommittee, ANZUP Cancer Trials Group, and Head of Urology, South Metropolitan Health Service, WA; A/Prof Tom Shakespeare, Director, Radiation Oncology, Coffs Harbour, Port Macquarie and Lismore Public Hospitals, NSW; Helen Anderson, Genitourinary Cancer Nurse Navigator (CNS), Gold Coast University Hospital, QLD; BEAT Bladder Cancer Australia; Mark Jenkin, Consumer; Dr Ganessan Kichenadasse, Lead, SA Cancer Clinical Network, Commission of Excellence and Innovation in Health, and Medical Oncologist, Flinders Centre for Innovation in Cancer, SA; A/Prof James Lynam, Medical Oncology Staff Specialist, Calvary Mater Newcastle, NSW; Jack McDonald, Consumer; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council WA; Tara Redemski, Senior Physiotherapist – Cancer and Blood Disorders, Gold Coast University Hospital, QLD; Prof Shomik Sengupta, Consultant Urologist, Eastern Health and Professor of Surgery, Eastern Health Clinical School, Monash University, VIC.
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