What Are the Possible Urinary Problems After Prostate Cancer Treatment?
Many men experience urinary problems as a side effect of prostate cancer treatment. This is because treatments can damage the nerves and muscles that control urination. It's essential to ask your doctor about the potential side effects before starting any treatment, as each one can cause different urinary issues.
How Common Are Urinary Problems After Prostate Cancer Treatment?
- Leaking urine: This is the most common issue, especially after surgery.
- Difficulty urinating: This can occur after various treatments due to scarring or swelling.
How to Manage Urinary Problems After Surgery (Radical Prostatectomy)?
Leaking Urine
Most men cannot control their bladder properly when the catheter is first removed post-surgery. This is due to temporary damage to the urinary sphincter and pelvic floor muscles.
What Can Help with Leaking Urine?
- Absorbent pads and pants: These can be worn inside or instead of underwear.
- Pelvic floor muscle exercises: Strengthen the muscles that control urination.
- Urinary sheaths: External catheters that drain urine into a bag.
- Bed protectors and handheld urinals: Useful for nighttime or long journeys.
- Penile clamps: These should be used sparingly and with caution.
If you still experience leaking six to twelve months after surgery, other treatments such as internal male slings, artificial urinary sphincters, adjustable balloons, or medications may be necessary.
What Urinary Problems Can Radiotherapy Cause?
Radiation Cystitis
Radiotherapy can irritate the lining of the bladder and urethra, leading to symptoms like frequent urination, burning sensation, difficulty urinating, and blood in the urine.
How to Manage Radiation Cystitis?
- Lifestyle changes: Drink plenty of fluids but avoid irritants like fizzy drinks, caffeine, and alcohol.
- Bladder wash: Treatments like hyaluronic acid can coat and protect the bladder lining.
Urinary Frequency and Urgency
Radiotherapy can cause an increased need to urinate or sudden urges.
What Can Help with Urinary Frequency and Urgency?
- Bladder retraining: Helps control when you urinate.
- Medications: Anti-cholinergics or mirabegron (Betmiga®) can reduce symptoms.
- PTNS and SNS: Electrical stimulation treatments to control bladder function.
- Botulinum toxin (BOTOX®): Injected into the bladder wall to prevent premature squeezing.
Difficulty Urinating
Radiotherapy can cause the prostate to swell or the urethra to narrow, leading to urine retention.
What Can Help with Difficulty Urinating?
- Catheters: To drain urine.
- Medications: Alpha blockers or 5-alpha-reductase inhibitors.
- Surgery: To widen the urethra or bladder opening.
How to Manage Urinary Problems After Other Prostate Cancer Treatments?
High-Intensity Focused Ultrasound (HIFU)
Possible issues include difficulty urinating, leaking urine, and urine infections.
Cryotherapy
Can cause similar issues, especially if you’ve had previous radiotherapy.
How Can I Help Myself?
Urinary problems can impact self-esteem and daily life. Here are some practical steps:
- Drink plenty of fluids: Aim for 1.5 to 2 litres (3 to 4 pints) a day.
- Avoid bladder irritants: Cut down on fizzy drinks, alcohol, and caffeine.
- Pelvic floor exercises: Regular exercises can strengthen control muscles.
- Maintain a healthy weight: Reduces pressure on the bladder and pelvic floor.
- Prevent constipation: Eat high-fibre foods and drink plenty of fluids.
- Quit smoking: Reduces coughing and pressure on pelvic muscles.
- Nighttime tips: Leave a light on or keep a container nearby.
- Plan outings: Know where public toilets are and carry a bag with essentials.
- Prostate Cancer UK Urgent Toilet Card: Shows staff you need immediate toilet access.
- National Key Scheme: Access to locked public toilets.
