Contents
Which treatments cause
urinary problems?
The following prostate cancer treatments may cause urinary
problems:
If you are considering which treatment to have for prostate
cancer, discuss the possible side effects with your doctor. You can
also speak to one of our specialist nurses by calling our Helpline.
Watch Paul's story for one man's experience of managing urinary
problems after prostate cancer treatment:
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What help is there for urinary
problems?
Let your doctor or nurse know if you have any urinary problems.
They will be able to offer advice about treatment, and may refer
you to an NHS continence service. These are run by nurses and
physiotherapists who specialise in urinary problems. Your GP can
also refer you to a continence service.
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What can I do to help
myself?
Making changes to your lifestyle may help.
- Drink
plenty of fluids (one and a half to two litres or three to four
pints per day). But avoid or reduce fizzy drinks, drinks that
contain caffeine (tea, coffee and cola), and alcohol.
- Regular pelvic floor
muscle exercises can help strengthen your pelvic floor muscles.
These muscles control urination.
These changes will help to reduce pressure on your pelvic floor
muscles.
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Urinary catheters
A urinary catheter is a narrow tube which is passed through your
penis into the bladder, or through a small cut in your abdomen (a
suprapubic catheter). It drains urine out of the body. You may have
a catheter for a short time after some treatments for prostate
cancer, including surgery, cryotherapy and HIFU. You may also use a
catheter if you have problems emptying your
bladder (urine retention).
Your nurse will show you how to use a catheter and how to look
after it. They will show you how to:
- empty the bag and how often
- connect a larger bag at night
- clean the catheter, and
- get a prescription for more supplies.
Urine infections can be common if you have a catheter. To help
prevent infection:
- wash your hands before and after handling your catheter
- wash the area where the catheter enters the body every
- drink plenty of fluids
- eat plenty of fibre to avoid constipation
- let your nurse know if the catheter is not draining properly,
and
- contact your doctor or nurse if you have any signs of a urine
infection.
Watch Paul talk about having an external
catheter.
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What if I leak urine?
You may leak urine because you have a problem with your bladder,
sphincter or pelvic floor muscles. Some men also leak urine when
they are sexually aroused or during sex.
There are a number of things
that may help:
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What if I dribble after I
finish passing urine?
Losing a few drops after you have finished passing urine is
common in all men, but is more likely if the pelvic floor muscles
are weak.
After you have finished passing urine, try tightening your pelvic
floor muscles once for several seconds or tightening and releasing
them a few times. This will push any remaining urine out of the
urethra and help stop the dribbling.
Or, wait a few seconds after you have finished passing urine and
then press gently behind the scrotum. Move your fingers forward
towards the base of the penis under the scrotum. This should push
the urine along the urethra and you can shake out the last few
drops.
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What if I pass urine
frequently and with little warning?
Some men need to pass urine more often and have a sudden urge to
go to the toilet. Sometimes they may leak before they get there.
This may be due to the bladder muscles contracting to push urine
out before you are ready.
There are a number
of things you can do to help:
- drink plenty of fluids - do not reduce your fluid intake as
this can make symptoms worse
- avoid drinks that might irritate the bladder such as fizzy
drinks, drinks containing caffeine such as coffee, tea and cola,
and alcohol.
- pelvic floor muscle exercises
- bladder retraining
- medicines
- a treatment called Stoller Afferent Nerve Stimulation (SANS) ,
and
- botox.
If you need to urinate frequently and notice that your urine is
dark, cloudy, smells or stings, you may have a urine infection and
should go and see your GP.
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What if I get up to pass urine a
lot at night?
If you have to get up to go to the toilet a lot at night, try
cutting down on any drinks in the last two hours before you go to
bed, particularly any alcohol, coffee or tea. Bladder retraining
may help, but you will need to train your bladder in the daytime
before you work on any problems at night.
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What if I have problems
emptying my bladder?
If your urethra becomes very narrow, you may not be able to
empty your bladder. Prostate cancer, some treatments for prostate
cancer, or other prostate problems such as non-cancerous benign prostatic
enlargement (BPE) can all cause this.
If you have a sudden and painful inability to pass urine (acute
urinary retention) it is important that you get treatment straight
away. You should contact your doctor or nurse, or go to your
hospital's accident and emergency (A&E) department. They may
need to drain your bladder using a catheter.
Some men may be able to pass some urine but leave more and more
behind in the bladder (chronic retention). Signs may include
leaking urine, wetting the bed, discomfort in your abdomen or
increased urine infections. You may need to pass urine more
frequently or urgently, your bladder still feels full or your
stream is weak.
Let your doctor or nurse know if you are having any of these
problems. Chronic retention is usually painless but it means that
you are not passing all of the urine. Your bladder slowly
stretches, which can weaken the bladder muscle. The urine left in
your bladder may cause an infection or bladder stones. Without
treatment, the build up of urine can overwork the kidneys and cause
them to fail.
There are several treatments
that can help.
- Medication can relax the muscles at the neck of the bladder or
shrink the prostate.
- You may be able to self-catheterise.
- Some men may need a long-term catheter
fitted through a small cut in their abdomen.
- An operation may help to widen the urethra.
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Where can I get
support?
Urinary problems can affect your self-esteem and your
independence. There is support available.
Your GP, continence nurse or specialist nurse will be able to offer
you practical and emotional support. The Bladder and Bowel
Foundation can also provide information. The manufacturers of
continence products may offer advice about using their
products.
You may find it helpful to speak to our support volunteers who are all
personally affected by prostate cancer.
There are also prostate cancer support groups throughout the country
where you and your family can meet other people affected by
prostate cancer. Some continence services also run local support
groups.
And you can join our online community.
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Questions to ask your
doctor or nurse
- Is the treatment I am having for prostate cancer likely to
cause any urinary problems?
- What type of urinary problems might I have?
- If I cannot pass urine what should I do?
- Will my urinary problems get better?
- What treatment is available?
- What else can I do to help myself?
- What are the risks and side effects of treatments for urinary
problems?
- Where can I get pads and other equipment?
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