Women are better able to learn and more willing to participate in self-care if their pain is well controlled. During the postoperative period the patient will need help adjusting to her altered body image. Many women will have to learn to care for a new colostomy or how to catheterize a continent urostomy. Women who have had a vulvectomy will need sensitive counseling to understand that she can still respond sexually. Patients who have had a vaginectomy with reconstruction as part of a pelvic exenteration will need extensive teaching to help them achieve successful sexual functioning.
Gynecologic surgeries can be very painful and disfiguring.
The oncology nurse must be willing to consult the endostomal therapist, licensed sex therapist, psych liaison nurse or any member of the health care team to ensure the woman the highest quality of life possible. Chemotherapy also has an impact on a woman's quality of life and sexuality. Many women find it difficult to respond sexually when they are feeling the fatigue, nausea and diarrhea that are common side effects of some chemotherapeutic agents. As part of the ongoing assessment of a patient, the nurse should ask if the treatments are interfering with the woman's relationship with her family and partner or her ability to respond sexually. Using this information, the nurse can intervene appropriately by obtaining pain medication, antiemetics or antidiarrheals.