Any medical procedure on the outer genitals carries some risk to sexual function. But so can other pelvic surgeries, including hysterectomies and surgeries to remove ovarian cysts or endometriosis tissue, in part because the clitoris is so interconnected with the nerve supply in that region.
To understand the risks of pelvic surgery and protect your future sexual sensation, it’s vital to discuss your genitals and sexuality openly with your doctor first, even if doing so feels awkward. Here are four questions to ask 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 should not be a first. If your doctor is vague or appears uncomfortable talking about these topics, “get a new doctor,” said Dr. Rachel Rubin, a urologist and sexual health specialist outside Washington, D.C.
What are the risks to my sexual sensation?
It’s important to share your concerns about arousal, orgasm and pain, as well as your preferences, as specifically as possible. Dr. Rubin said, “If you never tell your doctor how you experience pleasure, how can they assess if the side effects are relevant to you?” This may include asking how the procedure could affect non-genital areas like the anus, nipples and cervix.
Do your patients typically experience side effects?
Make sure your doctor reviews with you the most common side effects, which should also be listed on your consent form or post-op document. If a medical term is confusing or unfamiliar — for example, dyspareunia (pain during intercourse) or anorgasmia (inability to achieve orgasm) — ask your doctor to slow down and put it into everyday language.
If I do experience lasting sexual side effects, whom should I call?
Side effects to look out for include numbness, scarring, difficulty with arousal, 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 urogynecologist at Massachusetts General Hospital. If symptoms do not improve, ask your doctor to provide names of sexual health experts whom you can consult.