Objective To explore the sexual experience of patients with bladder cancer after radical cystectomy, to understand their difficulties and needs, and to provide reference for improving their sexual life quality after surgery. Methods A semi-structured in-depth interview was conducted in 15 patients with bladder cancer after radical cystectomy using phenomenological research method. The topic was extracted by Colaizzi 7-step analysis method. Results A total of 4 themes and 14 sub-themes were extracted: obvious symptoms of sexual distress (sexual dysfunction, interruption of sexual life); negative emotional distress (reduced self-esteem and self-confidence, anxiety and depression, fear and avoidance of sexual life); multiple changes in marital relationship (reduced intimacy, communication barriers, role changes, partner′s understanding and support); positive coping strategies and sexual rehabilitation needs (actively seeking medical help, trying alternative methods, psychological adjustment, facing challenges together with partners, expecting professional guidance on sexual rehabilitation). Conclusion The sexual life of patients after radical cystectomy is plagued by many aspects. Medical staff should pay attention to the sexual health needs of patients, provide individualized sexual rehabilitation guidance and psychological support, and improve the sexual life quality of patients.