You might get urinary problems if the cancer has spread to areas around the prostate, urethra and bladder (the urinary system).
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 or previous treatments for prostate cancer. Speak to your doctor or nurse if you have any of the symptoms described below.
Problems emptying your bladder
If the cancer is pressing on the urethra, causing it to narrow, you might have problems emptying your bladder fully. This is called urinary retention.
Treatments for retention include:
If you are suddenly unable to pass urine (acute retention) you should get treatment straight away, for example at a hospital A&E department. Acute retention is extremely painful and needs urgent treatment. Otherwise urine will build up in the bladder and may cause problems.
Problems leaking urine
If the cancer has grown into the bladder or any of the muscles that control urination, it can weaken them, and you might leak urine (incontinence) or need to urinate urgently.
If you leak urine there are things that can help. These include:
- incontinence products such as absorbent pads
- pelvic floor muscle exercises to strengthen the muscles that control urination
- medicines called anti-cholinergics, such as solifenacin succinate (Vesicare®)
- some men may need to have a catheter.
Rarely, problems emptying your bladder or having no control over when you empty it may be caused by a condition called metastatic spinal cord compression (MSCC).
Blood in your urine
Some men notice blood in their urine (haematuria). This may be caused by bleeding from the prostate. This can be alarming, but it can usually be controlled.
Speak to your GP or hospital doctor or nurse. Treatments include surgery or radiotherapy to stop the bleeding.
The kidneys remove waste products from the blood and produce urine. If prostate cancer spreads to the nearby lymph nodes or the bladder, it can cause problems with your kidneys.
Kidney problems can lead to high levels of waste products in your blood. This can cause kidney failure, which is a serious condition. Symptoms of severe kidney problems include tiredness and lack of energy, feeling sick, swollen ankles and feet from fluid retention, and poor appetite. Tell your doctor or nurse if you have any of these symptoms. They can also be caused by other things.
Treatments help to drain urine from the kidneys, and include:
- a tube inserted into the kidney to drain urine into a bag outside your body (nephrostomy)
- a tube (called a stent) inserted to allow urine to flow from the kidney to the bladder
- radiotherapy to shrink the cancer and reduce the blockage.
What else can help with urinary problems?
Urinary problems might affect your self-esteem and sense of independence. Speak to your nurse or GP 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 to help.
Read more about managing these problems, or speak to our Specialist Nurses. The Bladder and Bowel Foundation also provides information, including details of your local NHS continence service.