This study was conducted to determine whether patients could engage in sexual activity following total cystectomy with ileal conduit. Sixteen male bladder cancer patients treated by total cystectomy with or without preoperative irradiation. Patients ranged in age from 48 to 70 years (mean 59.6 years). The interval from therapy ranged from 7 to 82 months (mean 33.8 months).Prior to therapy 11 /16 patients (68.8 %) reported they were engaging some form of sexual activity at least once per month. All were able to achieve an erection and were orgasmic. Following total cystectomy, 6 patients (37.5%) continued to engage in sexual activity at least once per month and were experiencing orgasm. 3 patients (18.8%) reported they were able to achieve an erection. The spontaneous resumptiom of sexual activity by almost one third of the patients in this study refutes the assumption that sexual activity would be impossible following total cystectomy.