Controlling urinary problems after radiotherapy

After radiation therapy (also known as radiotherapy), some men experience problems with urinating. In some cases, these problems can last for a while and require medical treatment.

Managing urinary issues
after radiation therapy

Needing to urinate (wee) more often and difficulty urinating are two common problems after radiation therapy. To take control, there are things you can do at home and treatments your doctor might recommend. 

Needing to urinate (wee)
more often — urinary frequency

If you're experiencing urinary frequency, there are various treatments your doctor might recommend:

  • bladder retraining
    A specialist continence nurse or physiotherapist can give you information about a technique called bladder retraining that can help you control when you urinate and have to go less often.

  • medicines
    Anti-cholinergics are drugs that can help reduce frequency, urgency, and leaks. Speak to your doctor to explore if these can work for you.

  • percutaneous posterior tibial nerve stimulation (PTNS)
    A doctor places a needle under the skin, just above the ankle, and a low electrical current is passed through the needle. This affects the nerves that control urination, with the goal to stop the bladder from emptying before its full.

  • botox
    Having a botox injection in the wall of the bladder can help with urinary frequency and urgency.

Difficulty urinating

Radiation therapy can irritate the lining of your bladder and urethra, and make your prostate swell a bit, which can make it difficult to urinate (wee). It can be hard to start, may burn a little, and you may not feel like you’re emptying your bladder completely because the prostate might be blocking your urethra.

To help improve things, your doctor might recommend using:

  • a catheter to drain urine

  • surgery to widen the urethra or the opening of the bladder

  • medicines (alpha-blockers or 5-alpha-reductase inhibitors)

If you suddenly can’t urinate and it’s painful – head to your nearest emergency department, or call your doctor or nurse right away. This needs treatment immediately.

Maintain a
healthy lifestyle

Eat plenty of whole grains, beans, lentils, nuts, seeds, fruits and vegetables

Constipation can make your leakage worse by adding pressure against your bladder. Make sure you’re getting plenty of fibre daily to get your bowels moving. Start with small portions and gradually increase the amount of higher fibre foods in your diet.

Avoid alcohol

Drinking alcohol can make urinary problems worse. While you’re getting things under control, aim to cut back on alcohol as much as possible. Reducing the amount you drink, or not drinking at all, can help improve your symptoms.

Drink more fluids

When you don’t drink enough water and fluids, your urine (wee) becomes darker and more concentrated. This can irritate your bladder wall and cause leaks. Make sure you stay hydrated, avoiding any type of alcohol and caffeine, to improve your bladder control and bowel function. You can start by sipping fluids slowly throughout the day, versus drinking large amounts at once.

Reduce or quit smoking

Quitting smoking can improve your health all around. Talk to your doctor about options to help you stop smoking or gradually cut back.

Reduce caffeine

Some men will find it helpful to reduce caffeine, as caffeine can irritate the bladder and affect how well it works. Food and drinks with caffeine include:

• chocolate

• coffee

• tea

• fizzy drinks, such as Coca Cola & Pepsi

• energy drinks

More about steps to take for a healthy lifestyle

Safe exercise

In the early stages of recovery, you may need to adjust your exercise routine. High impact exercise can increase leakage. If your routine includes heavy strength training (using weights), reduce your weights. Speak to your doctor or nurse about a suitable exercise programme for you.

Know your medications

Some medications can affect your urinary health. Please talk to your doctor or pharmacist to ask any questions, and understand what you’re taking.

Avoid foods that irritate your bladder

Some foods can also irritate your bladder. These include spicy foods, some acidic citrus foods such as oranges and grapefruit, fruit juices, and tomato-based foods. You can try using a food diary to track how these foods might affect you. Eliminate these foods for about a week and re-introduce them back, one by one, to see if there is any change.

Talk to your
doctor, nurse or care team

If your leaking is heavy and preventing you from doing your usual daily activities, speak to your family doctor or a continence nurse specialist about getting help.
In the UK your GP can refer you to your local continence service or you can refer yourself.

Look for continence services
and resources online

Search your local community trust website for bladder and bowel or continence services. Alternatively, the Bladder and Bowel Community has a database which you can search to find a service near you.

Know where to
find a toilet

The National Key Scheme (NKS) offers a key that will help get you access to locked public toilets. If you live in Northern Ireland, these keys are available for a small fee from your local council office. Additionally, Macmillan can send you a free toilet card and key ring, which you can use to explain why you need the toilet urgently. Find out more here​.

To help ease your mind and to make sure you know where to find toilets when you’re out, you can use a toilet finder tool to find the public toilet nearest you.

Additional
Resources

Urinary problems after prostate cancer treatment
Why do some men leak urine after surgery?
How to manage urinary problems
How to do pelvic floor exercises
Leaking during sex

What's next?

Now that you've read up on Controlling urinary problems after radiotherapy, here are some related articles to explore as you continue to build your knowledge and understanding of this topic.
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