Pt.'s partner asked to have intercourse with a stoma !

[RN BSN 2009]

I'd help the pt and partner discover alternate forms of sexuality/affection.

[caroladybelle, BSN, RN]

Looking back, as a young person, didn't oral sex or even sex itself sound really bizarre? After all, straight heterosexual sex involves organs that excrete waste products going into another's body.

What is normal and "healthy" is in the eye of the beholder.

If a husband were to ask when he and his spouse and his spouse could resume sexual activity after childbirth, would we be as embarassed? If a husband asked the same question after his spouse had a hysterectomy/vulvectomy for cancer or cervical surgery, would we be flippant and say, "No, after surgery on the reproductive organs - no sex is allowed - what kind of person are you to ask such a thing?"

I think that most of us would ask the surgeon, what is permissable and when it is permissable, so that the individual w/cancer may enjoy the affections of their companion, and have a "normal" loving relationship with them, in as much as is able. And also encourage finding safe methods of enjoying each other.

It is rare to have the whole rectum removed and anus completely sewn shut. I really have not seen that much in practice. One would think that the surgeon would have discussed this matter with the patient beforehand.

From a purely analytical standpoint, just because someone as an ostomy, does not necessarily mean that ALL of the rectum/or colon was removed. If there is still some remainder there, the patient may still pass some mucous (natural shedding cells from the walls of the remaining tissue). There may also be some sensation which could be pleasurable, especially if that is how the patient got his enjoyment before surgery. The patient may still be able to enjoy some "manual" activities w/his partner - after healing and/or treatment w/chemo or rad - if okayed by the surgeon, who knows what/how much was removed. This should also be noted to the oncologist (in reference to possible pancytopenia if rad/chemo were used.

[azhiker96, BSN, RN]

When I'm surprised with questions I just say what I know and defer the rest to the doctor. In this case I'd say any use of the stoma is right out at this time. The patient needs to heal. For anything else, please talk to the doctor because I really don't know the risks of harm to the patient.

[muffin7]

I am so shocked/stunned, that i am about to start laughing!!!!!!!!!!!!!!

[pagandeva2000, LPN]

That's horrible. What a terrible way to teach you. She should have made you aware that non-medical people facing this condition might have questions in regards to their sex life and how you should answer them truthfully and with compassion. She didn't need to share this story to get her point across.

I'm not sure that this was a horrible method of teaching. Some people, no matter how educated they are can collapse in shock with some of the questions posed by patients. I'd rather experience the shock in the classroom rather than in front of the patient, which can hinder the progress of the nurse-patient relationship. I am sure that my face hit the floor several times when I first began working as a nurse. Now, I rarely miss a beat. I think I can appreciate an instructor like this.

[gentle]

Sorry - but I classify this story along with those "gerbil in rectum" tales - perhaps there is some truth to them, but they describe a minute fraction of the patient population and are usually endlessly repeated just for shock value and to justify viewing gay men as freaks. Depending upon the location, many ostomies are continually oozing, often smelly, and exude substances that cause tissue breakdown - and the person who is familiar with these facts and yet still thinks it is a reasonable alternative to a rectum for sexual entry would have to be nuts. I know a whole lot of gay men, and none of them fit this description!

With all due respect, this is not another "gerbil in rectum" tales. I have heard about the same situation. I have no doubt that I will encounter this as I have just started working for a county hospital.

Though, I too would caution against intercourse via stoma, I understand why the question was asked. This isn't an issue of gay men. This is an issue of a couple trying to navigate through learning how to bond. It is truly something to grieve over and will be a big adjustment. NCPs could include actual disturbance in self and partner concept, and alteration in self care.

As far as a point of sexual entry, the lady was prostituting. Though it wasn't a good decision, who knows why, she made that decision. I know of situations where people have chosen to strip, prostitute or whatever, to eat/provide for their family.

gotta run. take care everyone.

Gentle

[AZO49008]

Oh for cryin' out loud. Not THIS story again. I've read two or three other versions and variations on this at allnurses over the last year or so. Either it's someone walking in on a patient and the patient's partner is going at it, right there in the Hill-Rom or Stryker bed, having sex with the patient via the stoma; OR, it's a patient asking about the ability to have sex via the stoma. The other common theme among these stories is the they are all gay men.

Well, I'm calling ******** on these ridiculous stories. This is invariably some strange, sick urban legend that not only shocks and disgusts, but kills two birds with one stone by illustrating just how deviant and sick "the gays" really are. (I'm being sarcastic here to illustrate the purpose of this stupid story. I'm gay...I'm not saying gays are deviant and sick)

If I ever enountered anyone telling this ridiculous fable I'd call it out for what it is (********) and question their professionalism.

[diane227, LPN, RN]

Yes, I have had patients do this. I had one male prostitute who had a colostomy that he made a LOT of extra money by participating in this type of activity. He used to come in with the clap all the time.

[muffin7]

That is disgusting!!!!!!!!!!!!!!!!!!!

[flightnurse2b, LPN]

Oh for cryin' out loud. Not THIS story again. I've read two or three other versions and variations on this at allnurses over the last year or so. Either it's someone walking in on a patient and the patient's partner is going at it, right there in the Hill-Rom or Stryker bed, having sex with the patient via the stoma; OR, it's a patient asking about the ability to have sex via the stoma. The other common theme among these stories is the they are all gay men.

Well, I'm calling ******** on these ridiculous stories. This is invariably some strange, sick urban legend that not only shocks and disgusts, but kills two birds with one stone by illustrating just how deviant and sick "the gays" really are. (I'm being sarcastic here to illustrate the purpose of this stupid story. I'm gay...I'm not saying gays are deviant and sick)

If I ever enountered anyone telling this ridiculous fable I'd call it out for what it is (********) and question their professionalism.

with all due respect, as a paramedic who worked both in the ER and in the field, i can tell you these stories are not ridiculous....

it is incorrect to say that no one has sex with stomas, and it is not just limited to homosexual men. both homosexual and heterosexual people engage in behavior that some people say "eww" to, but it really DOES exist.

the stories about the gerbils, yes i've seen gerbils in the rectum and also even a garden snake in the vagina, i have had a pt use a potato as a pessary and forget about it until the eyes sprouted, the things people put in their anal canal including coke bottles, curling irons, butterknives, even an economy size cap from a tide bottle, pt tried to put hemorrhoid cream in his rectum with a broomstick and that got stuck, women who put ping pong balls in their vagina, forget to take their tampons out for weeks.......

yes. this stuff really happens.

[jmgrn65, RN]

Well this is certainly interesting...

[muffin7]

flightnurse2be

what is a pessary?