Changes in how your bladder works

Late effects on the bladder

Sometimes, people who have had pelvic radiotherapy notice changes in the way their bladder works. For some people, these changes start during treatment and don’t get better.

But sometimes bladder changes may develop months or years after treatment has finished.

Changes also happen as the bladder muscles age, so the symptoms below are more common as people get older. Women who’ve been through childbirth and menopause are also more likely to get urinary problems.

The bladder is a stretchy, muscular bag that collects and holds urine. It is in the lower part of the pelvis. It is connected to the kidneys (which produce urine) by tubes called the ureters. Urine drains from the bladder through a tube called the urethra.

The female bladder and kidneys
The female bladder and kidneys

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The male bladder and kidneys
The male bladder and kidneys

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The bladder is supported by the pelvic floor muscles. Some of these muscles wrap around the urethra. This is called the urethral sphincter, which keeps it sealed like a valve until you need to pass urine.

When the bladder is full, it sends a signal to the brain that you need to pass urine. When you’re ready, the brain tells the pelvic floor muscles to relax and open the urethra. The bladder muscles tighten (contract) and push the urine out.

Possible effects of surgery

Sometimes an operation to the rectum can affect the nerves to the bladder. These nerves control the muscles that hold urine in the bladder and also tell the muscles to squeeze to empty the bladder. Nerve damage can cause loss of bladder control leading to leakage of urine (urinary incontinence) or difficulty in emptying the bladder (incomplete emptying).

Possible effects of radiotherapy

Radiotherapy to the rectum and surrounding tissues (pelvic radiotherapy) often causes bladder symptoms that get better within a few weeks of treatment ending. It’s not common for radiotherapy to the rectum to cause long-term changes to the bladder, but a small proportion of people do notice changes to their bladder function several months after treatment.

Bladder symptoms due to the late effects of radiotherapy can include:

  • needing to pass urine more often than usual
  • a burning sensation when you pass urine (like cystitis)
  • being unable to wait to empty your bladder (urgency)
  • leaking urine (incontinence)
  • blood in your urine (haematuria)
  • difficulty passing urine.

Many of these problems can be dealt with successfully. We have more information on managing some of these symptoms.

Back to Long-term and late effects

Changes in how your bowel works

Treatment for rectal cancer may lead to changes in how your bowel works. These can usually be managed successfully over time.

Managing bladder problems

There are ways to manage changes in the way your bladder works. It’s important to talk to your doctor if you’re having problems.