The potential for sexual dysfunction for either men or women after pelvic pouch surgery is very small, but the risk does exist. Sexuality must be discussed with your surgeon prior to surgery.
For men, there is a less than one per cent chance of impotence or retrograde ejaculation. For women, there may be dyspareunia (painful intercourse) and vaginal dryness.
Anal intercourse should be avoided. The actual opening of the pouch (the anastomosis) is narrow and dilatation of this may damage the sphincters, resulting in possible leakage or incontinence.
Some women following pelvic pouch surgery will initially complain of pain with intercourse and vaginal dryness. The pouch sits in very close proximity to the vagina and if the pouch is full, pressure can be placed in the region of the vagina. Ensuring that the pouch is emptied and experimenting with different positions may help alleviate discomfort. Vaginal dryness can be due to hormonal changes following surgery. If it occurs, it is usually temporary and can be remedied through use of vaginal hydrating gels. There is no time restriction in terms of resuming sexual relations — the key is to be ready and comfortable. Keep open dialogue and share concerns/fears.