Life after stoma or internal pouch surgery has its challenges, not only in the gradual return to routine but in personal relationships. When seeking a new sexual relationship or navigating the return to an established one, anxieties around body image and fear of rejection can strike, yet these issues can be overcome through trust and open communication with your partner.

Award-winning stoma care nurse Kyle Waring, who created patient resources addressing intimacy after stoma surgery, answers our questions on sex and relationships.

Q. How and when should I tell a new partner about my stoma or internal pouch?

Telling a new partner about having a stoma or internal pouch is a personal decision, and the timing of wanting to tell them will come with feeling comfortable and having confidence but also feeling there is trust and open communication within the relationship.

A new partner who is interested in you as a person will likely be more concerned over other aspects of what makes you who you are such as your interests, your personality and your personal values as an individual.

The more open and more information you share together, the less difficult it can feel to share your body with somebody.

Q. How can I learn to like my body and feel sexy again after surgery?

There are many techniques which can help with feeling sexy again, and as with body image, it is about self-acceptance.

Remember that there is no timeline for when this should happen, and how quickly this should happen. Try wearing clothes that make you feel good and sexy as well.

Body image continually changes for each person, with or without a stoma. Even post surgery your body will change, and you must adapt to this new body, which can take time.

 

Q. My partner has seen me in my worst health – how can we renew our spark?

Explore sensuality and intimacy, which at its core is the feeling of close, personal connection. Encompassing trust and vulnerability, it not only focuses on the physical connection but also the emotional, intellectual and spiritual needs of you both.

Nurture each other, working through any questions that you both have for each other; also consider your partner might be feeling helpless. Try and get to know each other again, get to understand your bodies again, get to understand where you are comfortable being touched or where touch brings you pleasure, go on the journey together. Make it fun.

Q. If my partner wants us to return to our usual sex life and I don’t, is our relationship doomed?

The fear of rejection is something everyone experiences whether they have a stoma or not.

Effective communication is the key to any relationship; however, it can be difficult to discuss sex and have your views expressed clearly. When in a relationship, you should be able to talk openly and express how you are really feeling – remember it is okay to show vulnerability.

You don’t have to be comfortable with penetrative sex, but you can build up physical intimacy and explore where this brings you pleasure. Fittleworth has a useful guide which uses tools and techniques to help build intimacy, without penetrative sex needing to take place.

If your partner’s focus is on penetrative sex without considering your views and feelings following surgery, you should ask yourself if the relationship is worth damaging your self-worth.

Q. I feel embarrassed discussing my sexual health. Are all stoma care nurses trained to help with sexual concerns, or will they refer me for counselling?

You shouldn’t feel embarrassed to discuss any sexual health needs with the stoma care nurses. You should be able to discuss your sexual function or relationships with them.

Stoma nurse care is about seeing a patient holistically, caring for the whole individual, whether that be a physical problem, psychological or sexual problem. These issues are the same for both men and women, and how they experience the changes is personal to the individual; changes can take time to adjust. With the correct care and support system, many people return to normal activities.

• Visit Mid Cheshire Hospitals’ website to download their range of sex and intimacy guides.
• IA offers a counselling service, Support Through Therapy, for people experiencing prolonged emotional challenges relating to living with a stoma or internal pouch.