This topic is about a woman who has been living with chronic pain, depression, and a loss of intimacy five years after having a urostomy. She had her bladder removed due to severe interstitial cystitis, and although the surgery was meant to help, she continues to experience constant pain due to a nerve entrapment. This has significantly affected her life, making her feel house-bound and disconnected from her previous vibrant self. Her marriage has also suffered, with a loss of physical intimacy and closeness. She feels isolated, with no peer support or anyone to talk to about her situation. Here are some pieces of advice and insights that might help:

1. Attitude & Self-Image
- Regaining confidence can influence how others perceive you. Try to bring back some of your former habits like dressing up and doing your hair and makeup to help restore self-esteem.
- Remember, having an ostomy doesn't define you. Many people with ostomies lead full, active lives.

2. Re-engaging with Your Spouse
- Sometimes, husbands may fear causing pain or embarrassment. Simple non-verbal gestures, like holding hands while watching TV, can help rebuild closeness without needing a heavy conversation.
- Offer gentle reassurance that intimacy is still possible and welcome, giving him time to adjust.

3. Pain & Medical Management
- Consider seeking a dedicated pain-management consultation, as nerve pain can often be managed with specialized treatment.
- If local specialists are unavailable, think about traveling to larger centers for care, even if it's inconvenient or costly.
- Look into online resources for interstitial cystitis for diet and pain-control ideas.

4. Mental Health & Hormonal Factors
- If you've been experiencing depression for five years, it might be time to revisit professional help. This could include seeing a primary-care physician, counselor, or getting a GYN check-up, and considering medication if needed.
- Menopause, chronic pain, and body-altering surgery can collectively reduce libido. Recognizing this can help in seeking targeted medical and counseling support.

5. Peer Support
- Reach out to an ostomy association or local support group to connect with others who are living successfully with a urostomy. Shared experiences can help reduce feelings of isolation.

6. Hope & Perspective
- Long-term ostomates, some from childhood or 15+ years, report having full employment, family life, and even remarriage. There are partners who value inner qualities.
- Traveling for care, maintaining a positive outlook, and doing what you need to do can gradually help restore your quality of life.