Repercusiones de la estoma intestinal en la sexualidad de hombres: revisión integradora

Meira, Isabella Felix de Araújo; Silva, Fernanda Rios da; Sousa, Anderson Reis de; Carvalho, Evanilda Souza de Santana; Rosa, Darci de Oliveira Santa; Pereira, Álvaro

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Revista Brasileira de Enfermagem

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Sumário

REVIEW • Rev. Bras. Enferm. 73 (6) • 2020 • https://doi.org/10.1590/0034-7167-2019-0245 copiar

Repercusiones de la estoma intestinal en la sexualidad de hombres: revisión integradora

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivo:

Analizar las producciones científicas sobre las repercusiones de la estoma intestinal en la sexualidad masculina y discutir las implicaciones para el planeamiento del cuidado de enfermería.

Método:

Revisión integradora de la literatura, realizada en las bases de datos Scientific Electronic Library Online, Literatura Latinoamericana y de Caribe en Ciencias de la Salud, Sciverse Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature y National Library of Medicine and National Institutes of Health, sin recorte temporal preestablecido y utilizándose los descriptores “sexuality”, “ostomy”, “colostomy”, “men” y ”nursing”.

Resultados:

Han sido inclusos 21 artículos para componer el análisis interpretativa. Los estudios apuntaron que la estoma intestinal puede afectar la sexualidad masculina y reflejar negativamente en las dimensiones biofisiológica, psicoemocional y sociocultural.

Consideraciones finales:

Mediante estrategias de educación en programas que acompañen los hombres ostomizados desde el preoperatorio hasta la rehabilitación, la enfermera puede auxiliar en la adaptación a la realidad, así como en la calidad de vida.

Descriptores:
Sexualidad; Hombres; Estoma; Salud del Hombre; Masculinidad

Title/year/country of the study	Main results
Sexual experiences of Chinese patients living with an ostomy⁽¹³13 Zhu X, Chen Y, Tang X, Chen Y, Liu Y, Guo W et al. Sexual experiences of Chinese patients living with an ostomy. J. Wound Ostomy Cont Nurs [Internet]. 2017 [cited 2019 Jan 3];44(5):469-74. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28877113 https://www.ncbi.nlm.nih.gov/pubmed/2887... ⁾ 2017 China	Impacts on the quality of sexual life with the appearance of sexual dysfunction, changes in impulse, sex arousal, orgasm, and sexual satisfaction
Sexuality of patients with bowel elimination ostomy⁽¹⁴14 Moreira WC, Vera SO, Sousa GN, Araújo SNM, Damasceno CKCS, Andrade EMLR. Sexuality of patients with bowel elimination ostomy. Rev Pesqui: Cuid Fundam. 2017;9(2):495-502. doi: 10.9789/2175-5361.2017.v9i2.495-502 https://doi.org/10.9789/2175-5361.2017.v... ⁾ 2017 Brazil	Sexual inactivity in some cases and among the sexually active, reduced sexual desire, perceived lack of interest of the partner, changes in the frequency of sexual encounters
A descriptive, cross-sectional study to assess the quality of life and sexuality in Turkish patients with a colostomy⁽⁹9 Yilmaz E, Çelebi D, Kaya Y, Baydur H. A descriptive, cross-sectional study to assess quality of life and sexuality in turkish patients with a colostomy. Ostomy Wound Manage. 2017;63(8):22-9. doi: 10.25270/owm.2017.08.2229 https://doi.org/10.25270/owm.2017.08.222... ⁾ 2017 Turkey	Alteration of daily life and sexual activity routines; problems with erection, decreased libido and sexual satisfaction
Demands of care of stomatosized oncological patients assisted in primary health care⁽¹⁵15 Barba PD, Bittencourt VLL, Kolankiewicz ACB, Loro MM. Demands of care of stomatosized oncological patients assisted in primary health care. Rev Enferm UFPE [Internet]. 2017 [cited 2019 Jan 5];11(8):3122-9. Available from: https://periodicos.ufpe.br/revistas/revistaenfermagem/article/view/110217 https://periodicos.ufpe.br/revistas/revi... ⁾ 2017 Brazil	Social isolation and changes in lifestyle (the formation of gas and the odor from the pouch promote barriers to frequent specific social environments), changes in the way of dressing in order to hide the pouch, concern about self-image in front of the partner (a), decreased self-esteem and apprehension about the possibility of eliminating odor and feces during sex
Oncology ostomized patients' perception regarding sexual relationship as an important dimension in quality of life⁽¹⁶16 Kimura CA, Guilhem DB, Kamada I, Abreu BS, Fortes RC. Oncology ostomized patients' perception regarding sexual relationship as an important dimension in quality of life. J Coloproctol. 2017;37(3):199-204. doi: 10.1016/j.jcol.2017.03.009. https://doi.org/10.1016/j.jcol.2017.03.0... ⁾ 2017 Brazil	Changes in body image, in sexual function, marital adjustment and behavioral changes related to sexuality; problems with social relationships (feeling of exclusion and dependence)
Experiences and coping with the altered body image in digestive stoma patients⁽¹⁷17 Hueso-Montoro C, Bonill-de-las-Nieves C, Celdrán-Mañas M, Hernández-Zambrano SM, Amezcua-Martínez M, Morales-Asencio JM. Experiences and coping with the altered body image in digestive stoma patients. Rev Latino-Am Enfermagem. 2016;24(e2840). doi: 10.1590%2F1518-8345.1276.2840 https://doi.org/10.1590%2F1518-8345.1276... ⁾ 2016 Brazil	Fear of the new reality and the exercise of self-care related to the stoma; the emergence of emotional decline due to the need to handle the ostomy
The impact of an ostomy on the sexual lives of persons with stomas: a phenomenological study⁽¹⁸18 Vural F, Harputlu D, Karayurt O, Suler G, Edeer AD, Ucer C et al. The impact of an ostomy on the sexual lives of persons with stomas: a phenomenological study. J Wound Ostomy Cont Nurs. 2016;43(4):381-84. doi: 10.1097/WON.0000000000000236 https://doi.org/10.1097/WON.000000000000... ⁾ 2016 Peru	Discomfort during sexual intercourse, feeling of inability to engage in sexual intercourse, limitations in positions performed during sex, changes in body image and psychological problems such as anxiety and psychological distress
Sexuality of people with intestinal ostomy⁽¹⁹19 Cardoso DBR, Almeida CE, Santana ME, Carvalho DS, Sonobe HM, Sawada NO. Sexualidade de pessoas com estomias intestinais. Rev Rene [Internet]. 2015 [cited 2019 Feb 5];16(4):576-84. Available from: http://periodicos.ufc.br/rene/article/view/2750 http://periodicos.ufc.br/rene/article/vi... ⁾ 2015 Brazil	Altered body image, increased when facing self-image in front of the mirror, ostomy rejection, social isolation, fear of having sex, conflicting feelings, and concern
Gastrointestinal ostomies and sexual outcomes: a comparison of colorectal cancer patients by ostomy status⁽²⁰20 Reese JB, Finan PH, Haythornthwaite JA, Kadan M, Regan KR, Herman JM et al. Gastrointestinal ostomies and sexual outcomes: a comparison of colorectal cancer patients by ostomy status. Support Care Cancer. 2014;22(2):461-68. doi: 10.1007/s00520-013-1998 https://doi.org/10.1007/s00520-013-1998... ⁾ 2014 United States	Sexual dysfunction and psychological distress associated with changes in body image
Living with digestive stomas: strategies to cope with the new bodily reality⁽²¹21 Bonill-de-las-Nieves C, Celdrán-Mañas M, Hueso-Montoro C, Morales-Asencio JM, Rivas-Marín C, Fernández-Gallego MC. Living with digestive stomas: strategies to cope with the new bodily reality. Rev Latino-Am Enfermagem [Internet]. 2014 [cited 2019 Feb 5];22(3):394-400. Available from: http://www.scielo.br/pdf/rlae/v22n3/pt_0104-1169-rlae-22-03-00394.pdf http://www.scielo.br/pdf/rlae/v22n3/pt_0... ⁾ 2014 Brazil	Shame and discomfort due to gas, fear of lack of control over the body
Clinical profile and post-operative lifestyle changes in cancer and non-cancer patients with ostomy⁽²²22 Anaraki F, Vafaie M, Behboo R, Maghsoodi N, Esmaeilpour S, Safaee A. Clinical profile and post-operative lifestyle changes in cancer and non-cancer patients with ostomy. Gastroenterol Hepatol Bed Bench [Internet]. 2012 [cited 2019 Feb 15];5(1):26-30. Available from: 10.0000/www.ncbi.nlm.nih.gov/PMC4017481 10.0000/www.ncbi.nlm.nih.gov/PMC4017481... ⁾ 2012 Iran	Changes in diet, which affect weight loss, emotional changes (depression) and job change
A cross-sectional survey of quality of life in colostomates: a report from⁽²³23 Mahjoubi B, Mirzaei R, Azizi R, Jafarinia M, Zahedi-Shoolami L. A cross-sectional survey of quality of life in colostomates: a report from Iran. Health Qual Life Outcomes 2012;10(136):1-6. doi: 10.1186/1477-7525-10-136 https://doi.org/10.1186/1477-7525-10-136... ⁾ 2012 Iran	Impairments in sexual function and sexual pleasure
Health-related quality of life among long-term Rectal Cancer survivors with an ostomy: manifestations by sex⁽²⁴24 Krouse RS, Herrinton LJ, Grant M, Wendel CS, Green SB, Mohler MJ, et al. Health-related quality of life among long-term rectal cancer survivors cith an ostomy: manifestations by sex. Am J Clin Oncol. 2009;27(28):4664-70. doi: 10.1200/JCO.2008.20.9502 https://doi.org/10.1200/JCO.2008.20.9502... ⁾ 2009 United States	Prevalence in the development of erectile dysfunction and decreased return to sexual activity after ostomy surgery
The meanings of being a man with intestinal stoma due to colorectal cancer: an anthropological approach to masculinities⁽²⁵25 Dazio EMR, Sonobe HM, Zago MMF. Os sentidos de ser homem com estoma intestinal por câncer colorretal: uma abordagem na antropologia das masculinidades. Rev Latino-Am Enfermagem [Internet]. 2009 [cited 2019 Jan 5];17(5):664-69. doi: 10.1590/S0104-11692009000500011 https://doi.org/10.1590/S0104-1169200900... ⁾ 2009 Brazil	Body changes, apprehension about sexual activity (feeling of being less of a man, problems with desire and penile erection), inability to return to work (feeling of failure, disappointment, and marginalization for not being able to support the family)
The sexuality meanings for people with permanent bowel stoma⁽²⁶26 Paula MAB, Takahashi RF, Paula PR. Os significados da sexualidade para a pessoa com estoma intestinal definitivo. Rev Bras Colo-Proctol. 2009;29(1):77-82. doi: 10.1590/S0101-98802009000100011 https://doi.org/10.1590/S0101-9880200900... ⁾ 2009 Brazil	Coping with the refusal of family support, disengagement in social and work activities, denial of sexuality and refusal of sexual contact initiated by the other
Sexual health and quality of life among male veterans with intestinal ostomies⁽²⁷27 Symms MR, Rawl SM, Grant M, Wendel CS, Coons SJ, Hickey S, et al. Sexual health and quality of life among male veterans with intestinal ostomies. Clin Nurse Spec. 2008;22(1):30-40. doi: 10.1097/01.NUR.0000304181.36568.a7 https://doi.org/10.1097/01.NUR.000030418... ⁾ 2008 United States	Erectile dysfunction and reduced frequency of sex
Boundary breaches: the body, sex and sexuality after stoma surgery⁽²2 Manderson L. Boundary breaches: the body, sex and sexuality after stoma surgery. Soc Sci Med. 2005;61(2):405-15. doi: 10.1016/j.socscimed.2004.11.051 https://doi.org/10.1016/j.socscimed.2004... ⁾ 2008 Australia	Difficulty in dealing with altered appearance (bodily crisis), psychological distress (shame, loneliness, conflict, hatred, fear, sadness and depression), abstaining from intimate relationships, limits on positions held during sex and feeling less attractive to the partner
Experiences of Swedish men and women 6 to 12 weeks after ostomy surgery⁽²⁸28 Persson E, Hellstrom A. Experiences of Swedish men and women 6 to 12 weeks after ostomy surgery. J Wound Ostomy Cont Nurs. 2002;29(2):103-08. doi: 10.1067/mjw.2002.122053 https://doi.org/10.1067/mjw.2002.122053... ⁾ 2002 Sweden	Alienation of the body (decreased confidence, emotional shock, frightening experience when seeing the stoma for the first time, disgust), fear of hurting the stoma and feeling pain during sex, uncertainty about life with the stoma, difficulty in telling about the new reality to others, embarrassment due to loss of control over bowel movement, pain and skin rash around the stoma
Predischarge and postdischarge of persons with an ostomy⁽²⁹29 Pieper B, Mikols C. Predischarge and postdischarge concerns of persons with an ostomy. J Wound Ostomy Cont Nurs [Internet]. 1996 [cited 2019 Feb 2];23(2):105-09. Available from: https://www.ncbi.nlm.nih.gov/pubmed/8845888 https://www.ncbi.nlm.nih.gov/pubmed/8845... ⁾ 1996 United States	Concern about the ability to have sex, to participate in love games during sexual intercourse, to achieve pleasure during sex, and to be able to maintain the sexual interest of themselves and their partner.
Sexual functioning after ostomy surgery⁽³⁰30 Van De Wiel HBM, Weijmar Schultz CM, Hengeveld MW,Staneke A. Sexual functioning after ostomy surgery. J Sex Marital Ther. 1991;6(2):195-207. doi: 10.1080/02674659108406534 https://doi.org/10.1080/0267465910840653... ⁾ 1991 Netherlands	Reduced sexual arousal capacity (desire, erection, and lubrication) and orgasmic capacity
Sexual adjustment in ileostomy patients before and after conversion to continent ileostomy⁽³¹31 Nilsson LO, Kock NG, Kylberg F, Myrvold HE, Palselius I. Sexual adjustment in ileostomy patients before and after conversion to continent ileostomy. Dis Colon Rectum. 1981;24(4):287-90.⁾ 1981 Sweden	Reduced or absent sexual activity (the collection pouch emerged as a mechanical obstacle that interfered with sex)

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[1] Corresponding author: Fernanda Rios da Silva E-mail: enfafernandarios@hotmail.com