Managing urinary symptoms after prostate cancer treatment
Some treatments for prostate cancer can cause urinary symptoms. Urinary symptoms – particularly leaking urine (pee) – are most common after surgery for prostate cancer.
Many people feel upset or embarrassed by incontinence and urinary problems. You may find it affects how you feel about yourself and your dignity. Some men might avoid going out as much when they are troubled by urinary leakage because they worry about changing pads or having an accident. There are some tips to help you cope with urinary problems at the bottom of this page.
It is important to remember that you are not alone and help is available. It can help to talk to a nurse or to someone who has experienced urinary leakage.
You can call 1800 200 700 or visit a Daffodil Centre to speak with one of our cancer nurses in confidence or to be put in contact with someone who has had treatment for prostate cancer. You can also email the nurses at firstname.lastname@example.org.
What urinary problems might I have?
- Passing urine frequently (more than 8 times a day)
- A sudden urge to go to the toilet quickly (urgency)
- Getting up more than twice at night to pass urine
A slow flow of urine / difficulty emptying your bladder fully
A slow flow of urine may be caused by a narrowing of your urethra (water pipe) after surgery or radiotherapy. If you have a slow flow of urine or you’re getting a lot of urinary infections let your urologist know, so they can find the cause and see if you need treatment.
Leaking urine (urinary incontinence)
Leaking urine is a common side-effect of prostate cancer surgery. It can also happen if cancer is growing near the muscles which control the opening and closing of the bladder, causing them to weaken.
You may leak just a few drops of urine when you cough, laugh or exercise or it can be a constant drip or trickle throughout the day. Or you may leak some urine before you get to the toilet or after you have been. This usually gets better after a few weeks.
Your doctor, nurse or physiotherapist will tell you about pelvic floor exercises you can do, which may help to speed up the return of your urine control.
Acute urinary retention
Some men have problems passing urine. Occasionally, people find they cannot pass urine at all and cannot empty their bladder. This is called acute urinary retention. It is due to the narrowing of the tube carrying urine from the bladder. It can happen after radiotherapy or if the cancer is pressing on the tube.
If this happens, you'll need to go to the hospital emergency department where they will fit you with a small, thin tube (catheter) to drain your bladder, or your homecare team may do this for you. The urine will pass through the tube into a drainage bag. Before you go home, your nurse will show you how to look after the catheter. The catheter drainage bag will be worn inside your trousers and will be secured around your lower leg.
Some men may need a small operation to stretch the urethra and relieve the pressure on the narrowed urethra (water pipe).
Your bladder may become inflamed (cystitis) after radiotherapy. This may cause pain, discomfort or a burning sensation while passing urine. You may also feel the urge to pass urine frequently, both during the day and at night.
Sometimes you may find that you can only pass very small amounts of urine or none at all. Occasionally, blood may appear in your urine.
What you can do:
- Drink as much fluid as possible to help relieve symptoms.
- Drink cranberry juice or lemon barley water. Cranberry juice may not be advised if you are on certain medication, such as a blood thinner, so check this with your doctor first.
- Avoid alcohol, tea, coffee, carbonated drinks, acidic fruit juices such as orange juice, as they irritate your bladder.
Blood in the urine
You may notice blood in your urine (haematuria). This can happen after radiotherapy, sometimes years later. Tell your doctor if this happens so they can check out the cause. Often the bleeding is slight and no treatment is necessary.
With metastatic prostate cancer blood may be coming from your prostate gland. It can usually be controlled with surgery or radiotherapy.
Tips for coping with urinary problems
Cut down on caffeine
Cut down on food and drinks with caffeine, like cola, tea, green tea, coffee and dark chocolate, as they may irritate your bladder.
Drink less alcohol
Alcohol can increase the amount of urine you produce, making it more likely you’ll have to get up during the night.
Drink lots of fluids
Drink plenty of fluids every day – about 2 litres a day (average 6-8 cups). Not drinking enough will make your urine more acidic and this may irritate more. Avoid fluids with alcohol or caffeine.
Constipation can put pressure on your bladder and make urinary problems worse. Eat plenty of fibre to avoid constipation. Get some exercise, if you feel able to. Your doctor can advise you about suitable exercises for you. Read more about constipation
Have an afternoon rest
Resting may help the muscles around your bladder to tighten up and work better for you.
Pick the right pads
If you need to use pads, make sure you pick the right size and absorbency to suit you. Wear supportive underpants to help keep them in place and keep a supply with you.
Wear elasticated trousers
Wear trousers with an elasticated waist, or use braces rather than a belt. This makes it easier when you want to go to the toilet quickly.
Try pelvic floor exercises
Carry the card: The Irish Cancer Society has a card that you can show at shops and other public places to get urgent access to a toilet. Get one from a Daffodil Centre or by calling our Support Line on 1800 200 700.
For more information
1800 200 700