You might get urinary problems if the cancer is pressing on your urethra or has spread to areas around the prostate, such as the urethra and bladder.
Problems might include:
- problems emptying your bladder
- leaking urine (incontinence)
- blood in your urine
- kidney problems.
Some treatments for prostate cancer, such as surgery or radiotherapy, can also cause urinary problems. Read more about managing these problems.
Urinary problems can also be caused by an infection or an enlarged prostate. 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 your urethra or the opening of your bladder, you may find it difficult to empty your bladder fully. This is called urine retention. There are several things that can help, including the following.
- Drugs called alpha-blockers. These relax the muscles around the opening of the bladder, making it easier to urinate.
- A catheter to drain urine from the bladder. This is a thin, flexible tube that is passed up your penis into your bladder, or through a small cut in your abdomen (stomach area).
- An operation called a transurethral resection of the prostate (TURP) to remove the parts of the prostate that are pressing on the urethra.
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 nurse, or go to your nearest accident and emergency (A&E) department. They may need to drain your bladder using a catheter.
Cancer can grow into the bladder and the muscles that control urination, making the muscles weaker. This could mean you leak urine or need to urinate urgently. Ways to manage leaking urine include:
- absorbent pads and pants
- pelvic floor muscle exercises
- medicines called anti-cholinergics
- a catheter
Read more about things to help with leaking urine.
Your treatment options will depend on how much urine you’re leaking and what treatments are suitable for you. 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 Continence Product Advisor website has information about incontinence products.
If you find you need to rush to the toilet a lot and sometimes leak before you get there, find out where there are public toilets on the Great British Public Toilet Map website. Get our ‘Urgent’ toilet card to show to staff in shops or restaurants – this should make it easier to ask to use their toilet.
Rarely, problems emptying your bladder or leaking urine 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. It can be alarming, but can usually be managed. Your doctor might ask you to stop taking medicines that thin your blood, such as aspirin or warfarin. Speak to your doctor or nurse before you stop taking any drugs. You might also be able to have radiotherapy to shrink the cancer and help to stop the bleeding.
The kidneys remove waste products from your blood and produce urine. Prostate cancer may block the tubes that carry urine from the kidneys to the bladder (ureters). This can affect how well your kidneys work. Prostate cancer and some treatments can also make it difficult to empty your bladder (urine retention). This can stop your bladder and kidneys from draining properly, which can cause kidney problems.
Severe kidney problems can lead to high levels of waste products in your blood, which can be harmful. Symptoms 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 blood test can check how well your kidneys are working.
Treatments that can help to drain 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 ureter to allow urine to flow from the kidney to the bladder
- radiotherapy to shrink the cancer and reduce the blockage.
If you have kidney problems caused by urine retention, you may need a catheter to drain urine from the bladder.
Getting support for urinary problems
Urinary problems might affect how you feel about yourself and your sense of independence. If you are finding them hard to deal with, speak to your doctor or nurse.