You might get urinary problems if the cancer has spread to areas around the prostate, urethra and bladder. These might include:
- problems emptying your bladder
- leaking urine
- blood in your urine
- kidney problems.
Urinary problems can also be caused by other things such as an infection, an enlarged prostate, or prostate cancer treatments. If you have urinary problems, speak to your doctor or nurse. There are lots of things that can help.
Problems emptying your bladder
If the cancer is pressing on the urethra it might cause problems emptying your bladder fully. This is called urinary retention. Treatments include:
- a catheter to drain the urine from the bladder
- drugs called alpha-blockers to relax the muscles around the opening of the bladder, making it easier to urinate
- an operation called a transurethral resection of the prostate (TURP) - this may not be suitable for all men.
Acute urine retention
This is when you suddenly and painfully can't urinate - it needs treating straight away. Acute retention isn't very common in men with advanced prostate cancer, but if it happens, call your doctor or go to your nearest accident and emergency (A&E) department. They may need to drain your bladder using a catheter.
Problems leaking urine
Cancer can grow into the bladder and the muscles that control urination. This can make them weaker and could mean you leak urine or need to urinate urgently.
Ways to manage leaking urine include:
Your treatment options will depend on how much urine you’re leaking. If you find you need to rush to the toilet a lot and sometimes leak before you get there, finding out where toilets are before you go out may help you feel more in control of the situation. Get an ‘urgent’ card to show staff in shops, restaurants and other public places.
Blood in your urine
Some men notice blood in their urine. This may be caused by bleeding from the prostate. It can be alarming, but can usually be controlled.
You might need to stop taking medicines that stop the blood clotting, such as aspirin or warfarin. But speak to your doctor or nurse before you stop taking any drugs. You might also be able to have radiotherapy to stop the bleeding.
The kidneys remove waste products from your blood and produce urine. Prostate cancer may block the tubes that carry the urine from the kidneys into the bladder (the ureters). This can cause problems with how well your kidneys work.
Kidney problems can lead to high levels of waste products in your blood. This can cause a serious condition called kidney failure.
Symptoms of severe kidney problems include tiredness and lack of energy, feeling sick, swollen ankles and feet, and poor appetite. If you have any of these symptoms tell your doctor or nurse.
A simple blood test can check how well your kidneys are working.
Treatments that can help to drain the urine from the kidneys include:
- a tube put into the kidney to drain urine into a bag outside your body (nephrostomy)
- a tube (called a stent) put inside the ureters to allow urine to flow from the kidney to the bladder
- radiotherapy to shrink the cancer and reduce the blockage.
Information and support
Urinary problems might affect how you feel about yourself and your sense of independence. If you are finding it hard to deal with, speak to your doctor or nurse for help and advice.
Your GP can put you in touch with your local NHS continence service. This is run by specialist nurses and physiotherapists. They can give you advice and support about treatments and products that can help.
The Bladder and Bowel Foundation provides information, including details of your local NHS continence service. Visit continenceproductadvisor.org for information about incontinence products.