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Urinary Issues

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This page contains information about urinary issues relating to prostate cancer.

What are urinary issues?

‘Urinary issues’ is a term that refers to a variety of problems relating to the function of the bladder and urinary system. They are a common side effect of prostate cancer treatment, and the information on this webpage is about urinary issues related to prostate cancer.

Talk to your health care team about possible urinary issues before you start your prostate cancer treatment. If you are currently having prostate cancer treatment at one of our sites, please speak with your Nurse Navigator for a continence referral.

How common are urinary issues with prostate cancer?

Prostate cancer treatments affect everyone differently, but it’s quite common, and expected, that patients who are undergoing treatment will develop urinary issues.

How long the issues last after treatment finishes may depend on several factors, including your age, your weight and the physical characteristics of your urethra. Most people will eventually be able to control urination after prostate cancer treatment – especially if they are healthy and aged 40 to 60.

What causes urinary issues for prostate cancer patients?

The prostate is located under the bladder and around the urethra (the tube that carries urine from the bladder through the penis). This is why prostate cancer treatments affect the bladder and the surrounding muscles and nerves that control urination.

The prostate cancer treatments that commonly cause urinary issues are:

  • surgery – surgery and recovery can both damage the muscles and nerves that control urination
  • radiation therapy and brachytherapy – radiation may cause the prostate to temporarily swell and block the urethra, which causes urine retention. Radiation therapy can cause potential changes in bladder and bowel function in a small number of people.

The muscles that may be damaged include the:

  • pelvic floor muscles – the group of muscles that lie below the bladder and help control urination
  • urinary sphincter – the muscle that surrounds the urethra, sitting just under the prostate
  • bladder neck sphincter – the muscle that opens and closes your bladder.

What are the symptoms of urinary issues?

  • Frequent urination, especially at night
  • A burning feeling when you urinate
  • An urgent need to urinate
  • A weak flow of urine
  • Difficulty urinating
  • Blood in the urine
  • Leaking urine during sex or when you exercise, cough, sneeze or have an erection
  • A feeling of fullness in the abdomen
  • A feeling that you haven’t emptied your bladder fully
  • Difficulty retaining urine.

How are urinary issues treated?

Urinary issues can improve with time, though some people will experience ongoing issues. Treatments can help to reduce the symptoms and improve your quality of life. There are different options for treating urinary issues, including:

  • continence advice – speaking with a continence advisor can help you to understand all the options available to you
  • pelvic floor exercises – these can strengthen the muscles that control urination
  • absorbent pads and pants – designed to be discreet, pads can be worn either in or instead of your underwear to absorb leaking urine
  • urinary sheaths – these are soft silicone tubes that fit over the penis like a condom to collect urine and drain it into a bag strapped to your leg (under your clothes)
  • bed protectors – large pads (disposable or washable) can protect your sheets if you experience leaking urine at night
  • handheld urinals – these containers can be helpful if there is no toilet nearby or if you are experiencing frequent urination and can’t get to a toilet in time
  • bladder retraining – this is a type of behavioural therapy that helps you control when you urinate
  • medicines – some medications can help to reduce leaking urine, frequent urination and the urgent need to urinate
  • surgery – bladder surgery may help to widen the urethra or the opening of the bladder.

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