Intimacy, sexual function and relationships are widely considered to be important aspects of our psychological, physical and emotional welfare as humans. However, diseases which affect the colon, rectum or other pelvic organs may cause disruption to any active or potentiallysexually active individual, as may the treatment of such conditions or diseases, including chemotherapy, radiotherapy or surgery.
Sexual activity after surgery may sometimes improve, due to elevations in self‐esteem, reduction in pain or the restoration of continence.
However, for some the inability to resume sex, or embark on a life where sexual activity is no longer an option or has to be significantly altered, can be life‐changing.
Discussions by patients with healthcare professionals around resuming sexual activity may vary in quality and quantity, and patients often find it difficult to initiate such conversations. Taboo, embarrassment, cultural context, physical setting and individuals' personalities can all create barriers to open dialogue.
The language used is crucial and requires ‘emotional intelligence’ from healthcare workers to pick up on cues made by patients to navigate and normalise such conversations.
This leads to the risk that sex postoperatively may not be discussed or may only be discussed briefly and/or superficially, despite evidence that sex after surgery should be talked about during the counselling and consent process. Many, from their own and extensive anecdotal experiences believe that this remains lacking.
Issues regarding sex after colorectal and pelvic floor surgery are often overlooked by clinicians. Two members from the ACPGBI Patient Liaison Group (Nicola Dames and Sarah Squire) embarked on a pilot study to explore what matters to patients regarding sex after surgery. This is the first patient led piece of research to be published on such an important topic. The aim of the study was also to open a conversation amongst patients and discover whether sex is an important topic.
They aimed to explore the impact that colorectal and pelvic floor surgery has on the sex lives of patients and investigate whether adequate information, advice and support regarding sex are provided by surgical teams.
This survey was designed to be the patient and public involvement phase of a project to highlight important areas of discussion, difficulty and dilemma surrounding sex after surgery.
As patients it is vital we know where to turn if we need help, information, or support. They are Psychosexual Nurse Specialists, and patient support groups such as: