An ostomy is a surgical procedure carried out as part of the treatment of a number of diseases of the bowel or urinary tract, or to provide a method for managing incontinence, for example in the case of people with congenital disabilities such as spina bifida. A new passageway is created for the discharge of body wastes, through an opening called a stoma, onto the surface of the abdomen. A urinary ostomy may be one of several types of operation performed when there is a loss of bladder function. Urine then passes via a stoma into a bag.
There can be physical and psychological effects.
Any procedure which makes a person look or feel different is likely to have an effect on their body image so that there are anxieties about personal attractiveness. Additional anxieties occur regarding sexual ability, the effect of the ostomy on one's partner, and the possibility of an "accident" with embarrassing consequences occurring. If severe enough these anxieties may themselves contribute to impotence.
In both men and women, if the nerves to the sex organs have been cut or damaged by surgery, feelings in the sexual areas and libido may be diminished. In women vaginal lubrication may be less, so that KY jelly may be useful to increase comfort during sexual intercourse. Women who have had a colostomy may have some scarring in the sexual area, and the vagina may be less elastic and be in a slightly different position than before.
Any problems caused by this may be overcome by the woman having intercourse in certain positions such as lying on her side or on top of her partner. Many women with ostomies have no physical problems.
In men, as in women, after the surgery the sexual area may be sore for several months. In some cases the nerves which pass to the sexual organs may have been cut or damaged and if this has happened the man may be unable to get an erection or ejaculate or the ejaculation may be retrograde which means that the semen, instead of passing out in the usual way, passes back into the bladder. In this case men are no less masculine and there is still the possibility of being fertile.
The inability to get a complete erection is often temporary in which case erections will return in a few months. Anxiety or fear of failure can itself cause impotence. Remember that there is much more to sex than intercourse. One can make love with one's hands as well as the mouth or tongue. Many people enjoy masturbation. Most women find it easier to have an orgasm using these techniques so a man who is not getting an erection can still be a wonderful lover. Some people find a lot of pleasure from using sex aids and for some men who are unable to have an erection a penile implant may be a possibility.
An ostomy usually has no effect on the fertility of women, and most women are able to have a normal pregnancy and delivery. If the woman does not want to conceive, contraceptive precautions are necessary. Men may be sterile and/or impotent although this is by no means always the case. If a man is impotent but not sterile, he may be able to father a child by AIM (artificial insemination by husband).
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