What is radiation cystitis?

Pelvic radiotherapy can cause damage to the tissue and blood vessels in the lining of the bladder. It can cause inflammation and scarring of the bladder lining. This is called radiation cystitis.

Symptoms are common during radiotherapy treatment. The symptoms often get better. But sometimes they can start, or come back, months or years later after treatment has ended. This is called chronic radiation cystitis.

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, such as drinking plenty of fluids and the right types of fluids. But 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

Cystistat® (sodium hyaluronate) or iAluRil® are drugs that can be given directly into the bladder as a fluid (bladder instillation). They can coat the surface of the bladder to build up a protective layer to help relieve symptoms of radiation cystitis.

Usually, you lie down while a nurse gently passes a thin, flexible tube (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 half an hour (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, or 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 breath in pure oxygen. The oxygen travels in 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.

It is usually only used for severe symptoms after other treatments have been tried. HBO is not available everywhere and it is not always available on the NHS.

We have more information about hyperbaric oxygen (HBO) therapy.

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

  • References

    Below is a sample of the sources used in our pelvic radiotherapy information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk

    Andreyev HJN, Muls AC, Norton C, et al. Guidance: The practical management of the gastrointestinal symptoms of pelvic radiation disease. Frontline Gastroenterology, 2015; 6, 53-72.

    Dilalla V, Chaput G, Williams T and Sultanem K. Radiotherapy side effects: integrating a survivorship clinical lens to better serve patients. Current Oncology, 2020; 27, 2, 107-112.

    The Royal College of Radiologists. Radiotherapy dose fractionation. Third edition. 2019. Available from: www.rcr.ac.uk/system/files/publication/field_publication_files/brfo193_radiotherapy_dose_fractionation_third-edition.pdf [accessed March 2021]. 


  • Reviewers

    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. It has been approved by Chief Medical Editor, Professor Tim Iveson, Consultant Medical Oncologist.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.