Any medical intervention on the external genitalia carries a certain risk for sexual function. But so do other pelvic surgeries, including hysterectomies and surgeries to remove ovarian cysts or endometriotic tissue, in part because the clitoris is so interconnected with innervation in this region.
To understand the risks of pelvic surgery and to protect your future sexual sensation, it is essential to openly discuss your genitals and your sexuality with your doctor, even if it seems embarrassing to you. Here are four questions to ask yourself during your surgical consultation.
Can you show me the parts that will be affected?
Your doctor should be able to walk you through the procedure using diagrams or three-dimensional computer models, or by showing you your own anatomy. You may want to ask how often the doctor performs this procedure; ideally, yours shouldn’t be a first. If your doctor is vague or seems uncomfortable talking about these topics, “get a new doctor,” says Dr. Rachel Rubin, a urologist and sexual health specialist outside of Washington, D.C.
What are the risks for my sexual feeling?
It is important to share your concerns about arousal, orgasm, and pain, as well as your preferences, as accurately as possible. Dr Rubin said: “If you never tell your doctor how pleasure makes you feel, how can he assess whether the side effects apply to you?” This may include asking how the procedure might affect non-genital areas like the anus, nipples, and cervix.
Do your patients usually experience side effects?
Make sure your doctor reviews the most common side effects with you, which should also be noted on your consent form or post-surgery document. If a medical term is confusing or unfamiliar — for example, dyspareunia (pain during sex) or anorgasmia (inability to reach orgasm) — ask your doctor to slow down and put it into everyday language.
If I experience lasting sexual side effects, who do I call?
Side effects to watch out for include numbness, scarring, difficulty waking up, loss of sensation, hypersensitivity, and pain that does not improve. “I usually tell patients, ‘Every day you should feel better,'” said Dr. Emily Von Bargen, a urogynaecologist at Massachusetts General Hospital. If symptoms do not improve, ask your doctor for names of sexual health experts you can consult.
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