How colon cancer surgery can affect your vagina – the AP resection

One form of surgery for colon cancer is called an abdominoperineal (AP) resection, removing the lower colon and rectum. That is, the lower part of the bowel, plus the ‘tube’ faeces exits the body from. The process involves the creation of a colostomy so that stool can leave the body safely.

In younger women

Just the colon or rectum may be removed, however sometimes the uterus, ovaries and sometimes the back wall of the vagina must also be removed. A vaginoplasty may then be performed to repair the vaginal canal with skin grafts or skin and muscle.

Sex after colon surgery

The nerves are not damaged in the vagina or vulva during an AP resection, so sexual feeling is retained, and orgasm is entirely possible. Vaginal dryness can be a problem, particularly when the ovaries have been removed, since oestrogen is responsible for a large portion of vaginal moisture. Lube and vaginal moisturisers can really help, as can oestrogen cream.

Some sexual positions can be really uncomfortable or cause pain on penetration. There is scarring down to the tailbone, on the vaginal canal tissue, which can cause discomfort, so positions for each couple will need to be experimented with.

Ostomy bags during sex need to be managed, and this may involve certain positions being most comfortable, keeping the bag out of sight with clothing, and being careful, at least at first. Learn more about sex with an ostomy


There is often a loss of sexual confidence after pelvic surgery, since our most intimate parts are cut out, irradiated, poisoned and reshaped. It takes some getting used to the new you, and the interim can be emotionally very difficult. This can affect your sex life in negative ways. Having an understanding, kind and loving partner is one part of the solution, since being loved no matter what helps us regain confidence. The anatomy may not function like it used to, but an AP resection doesn’t mean no sex, interruptions to sexual function, and besides the ostomy and possibly some discomfort, nothing untoward should occur.

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