Radiation cystitis
Pelvic radiotherapy can cause inflammation and scarring of the bladder lining. This is called radiation cystitis.
What is radiation cystitis?
Pelvic radiotherapy can damage the tissue and blood vessels in the lining of the bladder. It can cause inflammation and scarring of the bladder lining. This can cause pain or a burning sensation when you pass urine. It can also make you feel like you need to pass urine frequently. This is called radiation cystitis.
These symptoms are common during radiotherapy treatment. They usually get better. But sometimes they can start, or come back, months or years after treatment has ended. This is called chronic radiation cystitis.
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What are the symptoms of radiation cystitis?
Radiation cystitis can cause pain or burning when you pass urine (pee). It can also make you feel like you need to pass urine frequently.
There are things you can do to help with symptoms. Drink plenty of fluids, such as water or de-caffeinated teas and coffee.
Try and avoid the following, as they may irritate the bladder:
- drinks with caffeine
- alcoholic drinks
- acidic food and drinks, including fruit juice and fizzy drinks.
Your specialist may also talk to you about treatments that can help.
We have information about coping with bladder changes.
Treatment to relieve symptoms
If you have ongoing symptoms of radiation cystitis, your specialist may talk to you about these treatment options.
Giving drugs into the bladder
Sodium hyaluronate (Cystistat®) and AluRil® are drugs that can be given directly into the bladder as a fluid. This is called bladder instillation. The drugs can coat the surface of the bladder to build up a protective layer. This helps relieve symptoms of radiation cystitis.
Usually, you lie down while a nurse gently passes a thin, flexible tube called a catheter through the urethra and into the bladder. The catheter may be lubricated with a local anaesthetic to reduce any discomfort. Any urine in your bladder is drained out through the catheter.
Then the nurse slowly passes the drug through the catheter. The catheter is removed and the drug stays in your bladder for at least 30 minutes to give it time to work. After this, you go to the toilet.
You may feel some discomfort when passing urine for a few days afterwards. You usually have this treatment weekly for a few weeks and then monthly until the symptoms improve.
Your doctor will explain more about the treatment and its possible side effects.
Hyperbaric oxygen (HBO) therapy
Hyperbaric oxygen therapy (HBO) can help bladder inflammation after pelvic radiotherapy.
During HBO, you go into a special room or small chamber and breathe in pure oxygen. The oxygen travels through your blood. The increased oxygen in your blood can help new blood vessels to grow and the tissue to heal in the area affected by radiotherapy.
HBO is usually only used for severe symptoms after other treatments have been tried.
There is limited evidence to support the benefits of HBO. HBO is not available everywhere, and it is not always available on the NHS. Your specialist can talk to you about this more.
If bladder problems do not improve
If your bladder symptoms continue or do not improve after having these treatments, your specialist may talk to you about other possibilities. When symptoms are severe, an operation to remove the bladder may be an option, but this is very rare.
We have information about coping with bladder changes.
About our information
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer.
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References
Below is a sample of the sources used in our late effects of pelvic radiotherapy information. If you would like more information about the sources we use, please contact us at informationproductionteam@macmillan.org.uk
C Helissey, S Cavallero, C Brossard et al. Chronic Inflammation and Radiation-Induced Cystitis: Molecular Background and Therapeutic Perspectives. PubMed. 2020 Dec 24;10 Available at https://pubmed.ncbi.nlm.nih.gov/33374374/ [accessed March 2026]
Urinary incontinence and pelvic organ prolapse in women: management. National Institute for Health and Care Excellence. (NICE) guideline Reference number:NG123 Published: 02 April 2019 Last updated: 24 June 2019. Available at https://www.nice.org.uk/guidance/ng123 [accessed March 2026]
R Dalsania, K Shah, E Stotsky-Himelfarb, S Hoffe et al. Management of Long-Term Toxicity from Pelvic Radiation Therapy. Gastrointestinal cancer- Colorectal and anal. Ascopubs April 2021. Available at https://ascopubs.org/doi/pdf/10.1200/EDBK_323525 [accessed March 2026]
LUTS in men. National Institute for Health and Care Excellence. (NICE) Last revised in June 2025. Available at https://cks.nice.org.uk/topics/luts-in-men/ [accessed March 2026]
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