Urostomy, colostomy or ileostomy

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 in the abdomen for getting rid of body waste (stool) from the colon. 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.

You can reduce the affect of a urostomy on your sex life if you take some common-sense steps. First, make sure the appliance (pouch system) fits like it's supposed to. Check the seal and empty your ostomy appliance 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. It is also wise to avoid foods like asparagus that give urine a strong odor. Some people now have continent urostomies that stay dry without an appliance. With a continent urostomy, a segment of the intestine is cut out. The ends are reconnected so the intestines can work normally. From the segment of intestine that was removed, a reservoir and nipple valve/stoma is built. The reservoir is connected to the ureters, which prevents backup into the kidneys. Urine is drained from the reservoir several times a day with a catheter you put through the stoma/nipple valve. There is no need for a bag to collect urine.

A nice pouch cover can make an appliance look less "medical." Patterns or ready-made covers are available from your enterostomal therapist or ostomy supply dealer.

Another choice is to wear a special small-sized ostomy pouch during sexual activity. Or, if you have a 2-piece system, turn the pouch around on the faceplate. Then 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. Or you can 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. You may also find that you feel more comfortable wearing a T-shirt to cover your appliance.

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

If you have a colostomy, you can do the same thing. Since a colostomy is not active all the time, you may be able to plan sexual activity for a time of day when you know yours is usually not active. If you irrigate your colostomy, you may be able to wear just a stoma cover or a small safety pouch during sex. You can also avoid eating foods that produce gas on days when you are likely to make love.

You can get more detailed information in our separate documents, Urostomy: A Guide, Ileostomy: A Guide, and Colostomy: A Guide. To get copies, call our toll-free number, 1-800-ACS-2345 (1-800-227-2345).

Laryngectomy

Laryngectomy is the surgery that removes the voice box. It leaves you without the normal means of speech and you breathe through a stoma 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 through the stoma. A scarf, necklace, or turtleneck can look attractive and hide the stoma cover. Even during sexual activity, a stoma cover may look more appealing than a bare stoma.

During sexual activity, 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 perfume.

Sometimes problems in speaking interfere with communication between some couples. If you have learned to speak using your esophagus, talking during lovemaking is not a big problem. It does take more effort though, 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 sexually by guiding your partner's hand or using body language.

Talking is not needed in many sexual situations. With a new partner, you may want to talk about the kinds of touching and positions you like before you start making love. You may also want to pre-select ways of signaling important messages you may want to share during sex.

Treatment for head and neck cancer

Some cancers of the head and neck are treated by operations that remove part of the bone structure of the face. Because these scars are so public, they can be devastating to your self-image. Surgery on the jaw, palate, or tongue can also change the way you talk. Recent advances in facial replacement devices and in plastic surgery now give many people a more normal look and clearer speech. Even ears and noses can be made out of plastic, tinted to match the skin, and attached to the face. All of these things can be a great help to a person's appearance and self-esteem.

Limb amputation

Treatment for some cancers, most often primary tumors of the bone, can include amputating or surgically removing a limb. Amputations may call for some changes in lovemaking. A patient who has lost an arm or leg may wonder, for example, whether to wear his or her artificial limb during sex.

The answer depends on the couple. Sometimes the prosthesis (or artificial part) helps with positioning and ease of movement. But the straps that attach it can get in the way. Without a prosthesis, the partner with an amputation may have trouble staying level during intercourse. Pillows can be used for support.

Amputations may create ongoing pain or pain where the limb used to be (this is called phantom limb pain). These side effects can interfere with sexual desire and distract a person during sex. If this is a problem, talk to your doctor about how to better control your pain.

Last Medical Review: 11/10/2008
Last Revised: 11/10/2008