Side-effects of muscle-invasive bladder cancer surgery

Older man touching his stomach

General side-effects: With all surgeries there is a small risk of bleeding and infection. Read more about general side-effects of surgery .

Bowel side-effects: There is a small risk that your bowel will become inactive and take a while to return to normal. This is known as paralytic ileus. It can happen after any surgery that involves handling of the bowel. There is also a very small risk of a bowel leak. This is because your bowel has been divided to take a part out and the two ends have been joined together .

Sexual problems: Surgery to remove your bladder and radiotherapy can cause damage to the muscles and nerves in your pelvic floor. This can cause physical problems when having sex. 


Shortening or narrowing of the vagina

For women, bladder surgery or radiotherapy might shorten or narrow your vagina. This can make sex uncomfortable. Regular gentle sex or using a special device called a dilator can help with this side-effect. Dilators are tampon-shaped plastic tubes of different sizes that you use with a lubricant. Your specialist nurse will advise you on how helpful a dilator may be in your situation and explain how to use them. You may feel embarrassed or uncomfortable but your specialist nurse will understand your concerns and will always respect your feelings.

Vaginal dryness

Radiotherapy to the pelvis can cause vaginal dryness. This can make having sex uncomfortable. Vaginal creams or moisturisers can be used regularly to help with day-to-day dryness. Vaginal lubricants can be used during sex to make it more comfortable and pleasurable. Hormonal creams and moisturisers can also help with vaginal dryness. Your doctor or nurse specialist can give you advice about the best products to help. 


Erectile dysfunction

Many men find it hard to get or keep an erection after surgery or radiotherapy for bladder cancer. This is called erectile dysfunction or impotence. There are medications and other treatments that can help with erectile dysfunction. For example, tablets, injections, vacuum pumps or implants to help you get an erection. 


After having your bladder removed you will be unable to father a child naturally. Read more about fertility. 

Sex after urostomy

Having a urostomy can affect how you feel about your body. You may also be afraid that the urostomy bag will become dislodged or cause damage to the stoma. Empty the bag before sexual intimacy and roll it up or tape it down so it will not get in the way, if you wish. If you need more advice talk to your doctor, specialist nurse or stoma nurse, they are all experienced in dealing with these issues.

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