More than a decade ago. impotence was almost universal after a cystectomy. With a nerve-sparing operation, it may be possible to preserve sexual function.

It is normal for you to have concerns about your sex life after having surgery for bladder cancer. With some simple planning, sex can be pleasurable and less stressful. Having a correct fit for your appliance (if you have one) and emptying it before sex reduces the chances of a major leak. You might wear a pouch cover or t-shirt during intercourse. To reduce rubbing against the appliance, choose positions that keep your partner's weight off the appliance.

After radical bladder surgery (radical cystectomy), a man no longer has semen because the prostate gland, which makes most of the seminal fluid, has been removed. Sperm cells are still made but they are simply reabsorbed with no ill effects. The feeling of orgasm is still the same but it will be "dry," that is, without semen.

There can also be some nerve damage after this surgery that may cause men to become impotent, that is, unable to have an erection. This problem could go away with time. Generally, the younger a man is, the more likely he is to regain full erections. Oral medications (like Viagra), vacuum devices, intracorporal penile injections, or intraurethral medication (Muse) may produce erections satisfactory for intercourse. Penile implants are reserved for patients failing medical therapy.