Pelvic pain after pelvic radiotherapy

Infection Back to top

Bladder infections (cystitis) can cause pain and a burning sensation, and are more common after radiotherapy. The pain is usually worse when the bladder is full and may be at its worst when you are passing urine or just afterwards. You may pass urine more often and your urine may be cloudy or smelly or have small amounts of blood. You may also feel ill, have a high temperature or feel sick (nauseated). 

Your urine will need to be tested to find out which type of infection you have so that the correct antibiotic can be prescribed.

Bowel changes Back to top

Spasm of the muscles lining the bowel can cause pain and is made worse when you open your bowels. The pain in this situation is cramp-like and may come in waves. Constipation or an anal stricture| can also cause pain. Sometimes the pain may be due to a split in the skin of the anus (fissure) and this causes a very sharp and intense pain when you open your bowels. To find out whether there are any changes in the bowel, you may be asked to have an examination of the bowel with a flexible sigmoidoscope|. This test is usually done by a gastroenterologist.

Fine cracks in the pelvic bones Back to top

Very rarely pelvic radiotherapy can cause tiny cracks in the pelvic bones some time afterwards. The tiny cracks are called pelvic insufficiency fractures and the pain can be quite severe.

See bone problems| for more information.

Cancer coming back Back to top

Pain can also occur if the cancer has come back and this is what many people who get pain worry about most. Your doctor can discuss with you the chance of your cancer coming back.

If the pain is caused by cancer it may:

• be there constantly and not go away when you rest
• get worse when you exercise or move around
• also be there at night and keep you awake.

The pain may not be very bad and may go away if you take mild painkillers. However, if you have this type of pain, your doctor should examine you and should arrange for you to have x-rays, a CT scan or an MRI scan, or a combination of these to find the cause.