Chapter 15: Sex and Pregnancy
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WARNING: This page contains material that is sexually explicit and openly frank about sexual issues and terms.
When you are fully healed from your Colostomy operation there is no reason why you cannot enjoy a full and happy sexual relationship with your partner.
When you first see your Stoma you may well imagine that you'd never be able to face sex again but the apprehension will fade away, especially when you get in the right circumstances!
Once you remove all your clothes there is no hiding the appliance. If you are involved in a genuine loving relationship your partner, and you, will soon be oblivious to the existence of the appliance.
Like I said facing a relationship is easier on the Colostomist's nerves if the partnership is already well established, especially if you're married. If this is the case your partner will most probably be with you while the surgeon explains the procedure, and if you have any questions about sexual function then discuss them with him. Of course, your Stoma Nurse will also be able to offer invaluable advice (as always) as this is a common area of worry and they will be used to frank discussions.
Recovery from a major operation takes time and you'll not be fit enough to make love for quite a while. As a rough guide you need to be able to successfully walk about a mile without too much pain or too many problems before you can consider yourself fit enough for intercourse.
If you find you are lacking in confidence try leading up to this with a session of heavy petting and foreplay. This may not be everyone's idea of fun, but the intimacy and tenderness involved helps break down any barriers that may exist, one thing leads to another and before you know it...
There is a chance that an Colostomy appliance can get in the way of things a little and there are a few tips that can help you.
Firstly make sure you are wearing a fresh appliance that is empty (if your bowels are empty and there is little chance of them working during the act then you can maybe wear the small pouch which will be less obtrusive. If using a large appliance try folding the end up and taping it to the skin.
A cotton cover is essential really, not only does it hide the appliance and looks more friendly but it prevents the plastic of the bag from chaffing your partners skin whilst you are sweating during intercourse.
The biggest problem for the male Colostomist is impotence. This is the inability to achieve erection and thus ejaculation. The nerves which control these functions (called the parasympathetic nerves) are located around the area of the bowel. Damage to these nerves may occur during the operation. If this happens erection may be difficult or impossible to achieve.
Your surgeon will make these dangers aware to you before surgery and will no doubt reassure you that the chances of this happening are very rare. I was warned of this by my surgeon and was concerned. It is only natural, so I contacted the British Colostomy Association. They told me that they are yet to be made aware of any nerve damage relating to a Colitis based operation, which is the main reason younger people have a Colostomy. However if the operation is necessary because of bowel cancer there is a possibilty of damage but again the chances are so minute it's hardly
worth mentioning. This is the most common reason for Colostomy in older males and by this time the sexual drive is likely to have dimished somewhat anyway.
If you think you have suffered a little bit of nerve damage please so not despair, it can take up to two years for permanent damage to be diagnosed. It may simply be a glitch in the system, a sort of post-operative stress.
Even if you were the unluckiest person in the world and you suffered total impotency from a colitis operation there is hope. New surgical techniques are constantly being developed to help the impotent male. Then, lets not forget Viagra! :-)
For the Female Colostomist there are different difficulties that may become apparent during intercourse.
The main problems revolve around the removal of the rectum. If you are not having your rectum removed these will not be relevant to you.
Firstly the wounds caused by the removal of the rectum (called the perenial wound) will be the slowest to heal and this can lead to pain if intercourse is attempted too soon.
Pain can also be experienced because of a slight shift in the uterus. This is a rare occurrence though, as is the chance of vaginal dryness.
Just as with the male's risk of impotency, there is a possibility of nerve damage for the female. In this case a loss of feeling will be experienced in the clitoris. This need not be total, and may be a slight loss of sensitivity but again it is so rare it's hardly worth mentioning, but your Surgeon is obliged to tell you all that goes wrong. It's all part of the surgeon-client consent form business.
If intercourse is painful due to the effects of the perenial wound, reconstructive surgery can be under taken to rid you of this problem. Until then, or if you don't want further surgery try to find the most comfortable position, you may well end up having to boycott the missionary position (the most common position). Be creative. Buy the Karma Sutra if necessary but don't endure pain because you are embarrassed to experiment. Your partner will be understanding and supportive, and only too keen to make sure you are comfortable, after all he wants you to enjoy it too!
If you are homosexual, male or female, there is no reason the stoma should be detrimental to your sex life. However if you are a gay male and have your rectum removed you will no longer be able to be receptive of gay sex. However your ability for erection and ejaculation should not be a problem.
If you are concerned about the removal of your rectum because of your sexuality discuss this with your Surgeon and Stoma Nurse.
Whatever happens you must not, under any circumstances, use the stoma for sexual entry. This is extremely dangerous and will certainly lead to further emergency surgery.
Having a Colostomy will not affect your ability to become pregnant. However if you wish to start a family or become pregnant again you do need to consult with your GP first. If the GP has any doubts (which is unlikely) then you may be referred back to the Surgeon to be sure and then to a gynacologist.
As a Colostomist you should not experience any difficulties during pregnancy arising from your Stoma. Unlike an Ileostomist who runs a greater risk of her Stoma blocking up due to pressure exerting on the intestine.
During pregnancy it is likely that your Stoma will change shape a little bit. If this happens you need to be sure your appliance still fits properly. Ask your Stoma Nurse to check this for you and be prepared to change to a different brand of appliance if necessary.
The delivery should be no more complicated than for a woman without a Stoma, however removal of the rectum may lead the specialist to discuss the possibility of a Caesarean Section delivery.
Whichever way the baby is delivered you'll need to change the appliance as soon as possible afterwards as the stoma will swell due to the pressure and strain exerted during delivery. When you and your husband are busy preparing the emergency labour kit (the bag of goodies most mums-to-be leave by the front door!), make sure you pack sufficient stoma supplies for your stay. With luck you'll deliver the baby in the same hospital you had your Colostomy and in which your Stoma Nurse is based, this way you can be visited regularly by the Nurse to have the stoma checked, just like you did when you had the Colostomy.