Bladder Cancer- “No Sex Drive/no Desire for Sex at All…”

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It’s killing our relationship so I’m looking for any information anyone could give me…he is seeing another dr tomorrow to talk about this…but he says he just has no sex drive/no desire for sex at all.

Men who have their prostates removed can experience serious long-term side effects. It is important to understand your risk of side effects and those therapies that can help you.
An important development that I have witnessed over the years for many different types of cancer procedures is open versus robotic surgery. I have linked an article comparing the two types of cystectomy below as well.
Have you been diagnosed with bladder cancer? Are you considering a radical cystectomy? Please scroll down the page, post a  question or comment and I will reply to you ASAP.
Thank you,
David Emerson
  • Cancer Survivor
  • Cancer Coach
  • Director PeopleBeatingCancer

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Bladder Surgery and Your Sex Life

“In the case of invasive bladder cancer, surgery is often part of the treatment plan. The surgery may involve a partial cystectomy (where only part of the bladder is removed) or a radical cystectomy (the entire bladder is removed). In men, this bladder surgery generally includes the removal of the prostate. This procedure can lead to loss of sexual function, with the critical factor being whether the bladder surgery damages the nerves near the bladder and prostate, according to Dr. White. He says there is about a 50/50 chance that a man’s sexual function will be affected by this surgery…”

NARUS 2018: A Contemporary Analysis of Robotic and Open Radical Cystectomy in Octogenarians

“Results: Mean age was 84.1 years, with a mean BMI of 25.5 kg/m2. A total of 43 patients had RRC while 132 had ORC. All patients undergoing RRC had intracorporal urinary diversion (ICUD). Patient characteristics were similar between RRC and ORC with respect to age, sex, race, smoking history, BMI, Charlson Comorbidity Score, and preoperative hemoglobin. Tumour and treatment characteristics were similar as well, with respect to clinical stage, receipt of neoadjuvant chemotherapy, and adjuvant chemotherapy. Patients undergoing RRC were more likely to have ileal conduit urinary diversion (91% vs 66%, p<0.01).

Pathological findings were similar with respect to pathological T stage (pT3/T4 51% vs 43%), variant histology (12% vs 8%), lymphovascular invasion (40% vs 39%), carcinoma-in-situ (44% vs 55%), total resected nodes (38 vs 43), node-positive disease (26% vs 26%), positive surgical margins (9% vs 8%). RRC was associated with significantly lower estimated blood loss (265mL vs 575mL, p<0.01), and transfusion rate (12% vs 39%, p<0.01). RRC and ORC were similar in terms of operating time, length of stay, 90-day complications rate, and perioperative mortality (all p>0.05). Multivariable logistic regression analysis was performed adjusting for age, preoperative hemoglobin, neoadjuvant chemotherapy status, and type of diversion.

Patients undergoing ORC were at a substantially increased risk of needing perioperative transfusion compared to RRC (OR 4.6, CI 1.6-12.7, p=0.004). Median follow up for the cohort was 13 months. There was no difference in recurrence-free survival (p=0.45) and overall survival (p=0.65) between RRC and ORC, and surgical approach was not a predictor of recurrence-free or overall survival.

Conclusion: The authors conclude that robotic RRC with intracorporal urinary diversion is safe and feasible in the octogenarian population. Compared to ORC, RRC was associated with significantly lower estimated blood loss and perioperative transfusions with equivalent pathological and oncological outcomes. RRC was an independent protective predictor for needing a transfusion after controlling for confounders.

Comments from around the Internet about Bladder Cancer and Sex…

My boyfriend of 2 years had Rc surgery in nov. 2012. It has been 4 months since surgery and his bladder almost under control but be is still wearing 1 pad a day. He is back to feeling normal but states he completely lost his sex drive. He has tried viagra once and Levitra twice and neither have worked. He has a penis pump he has tried a few times but hates using it. They checked his test. Levels and they are in the normal range..360 but the lower end. We live together…still hold hands at kiss but that’s about it. We no longer go to bed at the same time or cuddle since he has no interest in any of that if he can’t have sex.

It’s killing our relationship so I’m looking for any information anyone could give me…he is seeing another dr tomorrow to talk about this…but he says he just has no sex drive/no desire for sex at all.

My boyfriend is 37 and I am 41… In case you were wondering.

I am 55 and just had surgery, sex is the last thing on my mind right now. This is a life changing event and I couldn’t imagine going through it at 37. Your boyfriend seems to be proactive, but I suspect these things take time and he has a lot on his mind. One of the reasons I chose my physician was for his reputation of being able to spare nerves, however, he said not to expect things for about a year. I would suspect things will get better, but you should remain supportive and patient, he needs that right now.

Just my opinion

You are both young, I was 57 when I lost my sex tool. I feel going to a ED dr. is the best way to go. Blood work for b/12 and testone{, check the spelling of that}. It does take time for the nerves to heal and your brain on what just happened to you. At first I did not think of sex but now I am. Just glad for the memories. I am sure others will post and there is a video from a D r from Ny who talks about this problem. Look on this site it will come up.
best to you

I lost my bladder and prostate at age 58. Haven’t had an erection or sex since June 1, 2009. My doctors said that there were things they could do, such as the pump, implants, and injections, but my wife nor I have pursued them.

It is difficult to imagine the enjoyment of the sexual experience with “the bag flopping around”. I give a new definition to sexy.

Sorry, but in 4 years we have not found an acceptable solution.


I don’t know, maybe I just have a different perspective. I could care less about the sex. We have been married 35 years, I am much more concerned about just keeping my husband alive for a few more months.True love has always meant more than just sex to us. I’m not saying that sex wasn’t an important part of our married life together, what I AM saying is that if you truly love someone, then in the face of cancer, and the possibility of losing that one person who is your entire life – well, there are other more important things.

If you truly love your boyfriend, then stick by him and try and understand what he is going through. He may or may not EVER be able to be sexually active again.

In a perfect world, your boyfriend would be well, and you wouldn’t have to deal with the sex issue. But this isn’t a perfect world. I certainly hope that there WILL be an answer, and that the doctors can help, but that may not be the case. If not – you two will find out just how deep your love truly is.

I honestly wish you both the very best.


For God’s sake, don’t you realize what he has been through? Him being alive isn’t enough for you right now?
I guess it’s killing your relationship in your eyes only? 120 days…
I cannot believe the number of people here, that imply sex is the ONLY thing that keeps a relationship together.

Sex was the last thing on my mind after four months. Worrying if I was going to wet my pants in public, weighed
a little more heavy on my mind than sex. Or maybe it was that I was wearing depends waaaay earlier in life than I expected.
Or maybe it was the 28 lb weight loss. Or maybe it was that I just generaly felt like shit. Or maybe it was I was wondering if/when I would feel better/normal again. Or maybe it was I just had everything from my a-hole forward removed.
If sex is THAT important to you, maybe you should move on. If not, be patient.
Woody returned for me in about 6 mont
hs, but I had prostate capsule sparing. You do not mention if he had nerve, capsule sparing,
or nothing.

Sorry, obviously, this is a sore subject with me.

His nerves were spared as far as we know. I’m not concerned about having sex again. It appears I may come off as under caring and cold and I assure you this is not the case. My concern is not the sex. Its about feeling close again..the cuddling..laying in bed..touching each other or at least holding each other. I love this man. I have no intentions of us ever breaking up. I just was curious if he just needs more time and I am hoping that things work out for us. He has no bag as the dr rebuilt his bladder. He has no weight loss only weight gain but still at a normal weight. He thinks his penis has shrunk but I haven’t seen it since the day before surgery so I have no clue if this is true or not. He is going to see a dr to see if maybe there is something they can do about his sex drive…I’m sure he misses it too. I’ve read other posting about people/sex on the site and it appears some have a drive and some don’t. I thought it was just him and therefore maybe the problem had more to do with me…it appears that is not the case. Any further advice is welcomed…I am very thankful to have him alive and love him..I want the best for us.

Your question and concern is certainly to be expected. It does not say to me that you love him any less nor misunderstand what he gas gone through. You are simply trying and hoping to restore/re-vitalize, etc. your loving relationship. Just keep giving him more time to live with the new life he’s been dealt — it is tough but I suspect he will gradually improve.

Best wishes & prayers for you both,


You might want to read my journal. It covers some of your issues.

Slickvic, Let me assure you, in terms of recovery from RC, Nov 2012 is like yesterday, because the R stands for RADICAL. Most survivors speak to taking at least 6 months to reach a “new” normal. The new normal is just that………..new, and unlike before. However, at his age there is a good chance the sexual proclivities will return. Trying too hard, this soon, can most certainly be counter productive. I can’t see how any ED drug or apparatus will be satisfactory without desire. Give it time and he’ll be chasing you around the bedroom again, then, if need be, seek a solution for ED. By forcing the issue, you’re most likely creating more problems. Take it easy, give it more time and do not focus on the ED. Roybean

Thank you

David Emerson




















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