Managing bladder problems after pelvic radiotherapy

Sometimes pelvic radiotherapy can cause long-term changes to the way the bladder works. There are general things you can do to help reduce bladder symptoms.

About bladder problems after pelvic radiotherapy

Sometimes pelvic radiotherapy can cause long-term changes to the way the bladder works. These changes may start during treatment and not get better. Or the changes may develop months or years after treatment.

Bladder problems can be embarrassing and difficult to talk about. But if you are affected, it is important to talk to your doctor. There are many things that can be done to help.

Your GP can advise you, or they may need to refer you to:

  • a specialist doctor in bladder problems (a urologist)
  • a specialist nurse or physiotherapist who gives continence advice and treatment (a continence adviser).

Tests to check for bladder problems

If you have bladder problems after your treatment, your doctors will usually arrange some tests to find out the cause. Your GP can test your urine to check for infection. They can also do blood tests to check how your kidneys are working.

Further tests after treatment

Some people may need further tests arranged by a urologist or a continence adviser. These include the following:

  • A cystoscopy

    cystoscopy looks inside the bladder. During this test a thin, flexible tube with a light on the end (a cystoscope) is passed through your urethra and into your bladder. This is usually done using a local anaesthetic.

  • Urodynamic tests

    Urodynamic tests check how well your bladder and urethra collect, hold and release urine. These are usually done to find out the cause of incontinence.

Treating bladder problems after pelvic radiotherapy

We have more information about treating the following bladder problems after pelvic radiotherapy:

What you can do

Here are some general things you can do to help reduce bladder symptoms. We also have information about coping with bladder changes that may be helpful.

Drink plenty of fluids

Try to drink at least 2 litres (3.5 pints) of fluids a day. This is about 8 glasses. If it is hot or if you are exercising, you will need to drink more than this. It is best to drink regularly throughout the day.

Drinking too little will make your symptoms worse. Urine that is concentrated irritates the bladder. Drinking more fluids will:

  • reduce bladder irritation
  • train your bladder to hold more urine
  • reduce your risk of getting urine infections.

Drink the right fluids

Some drinks can irritate the bladder and make symptoms worse. Cut down or avoid:

  • alcohol (especially spirits)
  • fizzy drinks
  • drinks that contain caffeine (such as tea, coffee, cola and cocoa)
  • acidic drinks (such as fresh orange or grapefruit juice)
  • drinks with artificial sweeteners (‘diet’ or ‘light’ drinks).

Try to drink water, diluted fruit juice and herbal teas.

Try not to go to the toilet ‘just in case’

If you go to the toilet as a precaution, your bladder will not get used to holding more urine.

Give up smoking or vaping

If you smoke or vape, ask your GP about getting help to give up.

The chemicals in smoke from cigarettes and e-cigarettes irritate and damage the lining of the bladder. This can make your symptoms worse. Smoking or vaping can also make you cough more. Coughing may make you more likely to leak urine. Smoking is also a major risk factor for cancer and other serious health conditions.

We have more information about giving up smoking that you may find helpful.

Avoid putting extra pressure on your pelvic floor muscles

To help avoid putting extra pressure on your pelvic floor muscles, try to:

  • keep your weight within healthy limits
  • avoid getting constipated
  • avoid heavy lifting.

It is especially important to do this if you have stress incontinence.

Find ways of reducing stress

Feeling anxious can make you feel like you need to pass urine. It can also make your symptoms worse.

Getting support

Macmillan is here to support you. If you would like to talk, you can do the following: