Changes in how your bladder works

Some people have problems with bladder control after treatment for rectal cancer. Changes also happen as the bladder muscles age so they are more common as people get older.

The bladder is a stretchy, muscular bag that collects and stores urine. It’s in the lower part of the pelvis. The bladder connects to the kidneys (which produce urine) by tubes called the ureters. You pass urine from the bladder through a tube called the urethra.

The bladder and kidneys
The bladder and kidneys

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Possible effects of treatment

When it is relaxed, the bladder stores urine. It then contracts to expel urine. The effects of treatment may mean that the bladder needs re-training.


Sometimes an operation to the rectum can affect the nerves to the bladder. These nerves control the muscles that hold urine in the bladder. They also tell the muscles to squeeze to empty the bladder. Nerve damage can cause loss of bladder control. This can lead to leakage of urine (urinary incontinence). Or, it may cause difficulty in emptying the bladder (incomplete emptying).


Radiotherapy to the bowel often causes bladder symptoms. These usually get better within a few weeks.

It’s not common for radiotherapy to cause long-term changes to the bladder. But a few people may have changes to the way their bladder works 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.

If you have any of these symptoms it’s important to have them checked by your doctor. Blood in the urine should always be checked by a doctor straight away.

We have more detailed information about bladder changes due to radiotherapy.

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.