Do Men Become Impotent After A Colostomy Or Ileostomy?

Many People Think An Ostomy Means A Man Can No Longer Have Sex

Couple Behind Umbrella
Impotence after surgery may only be temporary, and once the cause is found, it can be treated. Image © Cultura/GretaMarie / The Image Bank / Getty Images

One of the many concerns people with inflammatory bowel disease (IBD) may have about abdominal surgery, and especially colostomy and ileostomy surgery, is how it will affect the genital area. Women are typically concerned with the ability to conceive and give birth, and what affect any scarring might have on their reproductive organs. Men are typically concerned about the potential for impotence (the ability to retain an erection) and the ability to father children.

Abdominal surgery for IBD and other conditions has advanced dramatically over the years. The greatest risk of developing sexual problems after colostomy surgery is in men who have had the surgery to treat rectal cancer. Men who have ostomy surgery to treat IBD have a much lower risk of problems. This is an area that is not well researched, even though it affects a basic human need that drastically affects quality of life. The good news is that even if a sexual complication does occur, there are treatments available. Even though the topic can be embarrassing, talking about it with healthcare professionals can lead to getting help and solving the problem, whether it be for the body image issues that are common in people with IBD or for erectile dysfunction. 

Why Ostomy Surgery Might Be Done

Colostomy and ileostomy are two types of ostomy surgery that are done to treat Crohn's disease. Ostomy surgery is also used to treat other types of digestive disease, including colon cancer and diverticulitis.

For ulcerative colitis, only ileostomy surgery is done as a treatment.

The good news is that ostomy surgery does not always cause impotence in men. The genitals are not directly affected by these surgeries used to treat digestive disease. However, impotence is a risk in this type of abdominal surgery, particularly in the more extensive surgery that is done to treat cancer.

Impotence is more common after colostomy surgery than it is after ileostomy surgery.

When Impotence Might Occur

Unfortunately there is little research on the sexual effects of ostomy surgery in patients with IBD. However, one published report indicates that rates of impotence are low -- potentially between 2% and 4%.

Some men may experience temporary impotence after undergoing ostomy surgery. In some cases, the reasons for this may be unclear at first, and getting a proper diagnosis can help improve the outcome. Impotence can also be the result of a variety of concerns including a poor body image and the overall difficulty in recovering from surgery. Convalescing from surgery can take some time, and any complications can also delay recovery and a return to the pre-surgical sexual activity level.

There are several treatments available for permanent and temporary impotence, including medication, penile implants, and counseling. The treatment used will depend upon the type of impotence a man has.

How To Talk To Your Doctor

Sexual function is certainly a challenging one to begin discussing with anyone. Physicians may not ask about sexual problems after ostomy surgery, leaving it for the patient to bring up. One strategy is to write down questions on paper, or send them via email or text to have them answered. Having a partner attend doctor's visits is common and very helpful when it comes to remembering information afterwards, but if that would cause more embarrassment, a solo visit with a doctor may work out better. Asking for a referral to a physician who specializes in erectile dysfunction or sexual problems can also help, as these doctors deal with this subject all day long, and may be easier to talk with. 

It might be a difficult discussion, but the sooner the problem is brought up, the sooner it can be addressed and quality of life, including enjoyment of sex, can be improved.


Christensen B. "Inflammatory Bowel Disease and Sexual Dysfunction." Gastroenterol Hepatol (N Y). 2014 Jan; 10(1): 53–55.

Hollister. "Love and Sex." Hollister Global. 2013.

National Digestive Diseases Information Clearinghouse. "Facts and Fallacies About Digestive Disease." National Institutes of Health. Apr 2000.

Wittenauer J. "Caring for the Ostomy Patient." National Center of Continuing Education. 2007. [PDF]

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