(PM-19) Shame, desire, anger, fear and hope: what fits in a urostomy bag?

Abstract Introduction The objective of this study is to investigate the experiences and perceptions of Brazilians patients with bladder cancer who have undergone radical cystectomy and use urostomy bag. Methods We performed a qualitative study that included six patients that were operated between August 2017 and December 2023. We performed semi structured interviews with a guiding script that addressed the patients’ perceptions about the use of the urostomy bag and changes in self-image and sexual life. Content analysis was carried out, using thematic categories defined a priori and during data analysis. Results We interviewed two women and four men, aged between 55 and 80 years. The first perceptions about the bag after the surgery were fright, followed by the feeling of being different from other people and being observed by everyone. Later perceptions took on two contradictory directions: while some patients reported gratitude and affectionately called the bag “my pet” or “my little friend,” others made efforts to clean it without the presence of other people and to always hide it under their clothes. All men reported no longer having an erection and were sad and resigned. One patient was oriented to use pro-erectile medication, but did not consider the response satisfactory. One female patient reported not having sexual intercourse for fear of pain during penetration and the other reported not having sexual intercourse because of the shame of using the bag. Conclusions Patients showed important changes in their auto image and ambivalent perceptions about the use of the urostomy bag. In their discourses on sexuality, the patients showed a penetration-centred perception of sex and, despite feelings of sadness and fear, none of them reported attempts at new forms of sexual intercourse. Psychosexual care, within a multidisciplinary perspective, can help patients in the elaboration of their grief and help them to expand their sexual repertoire. Financing No conflict.