Penile Cancer

Using the toilet

Immediately after surgical treatment for penile cancer, men may have to use a catheter for a few days in order to pass urine. Depending on the extent of the surgery, they may have to make adaptations to how they use the toilet after the catheter is removed.
 
Catheters
Many of the men we interviewed talked about having to use a tube (catheter) from their bladder to urinate for a few days after being treated. There are many different types of catheter each with slight variations or made by different companies. Some of the catheters the men used are no longer available because we have learnt about better ways to use them. Consequently, there is usually little choice about the catheter you use as it largely depends on what is available to the health professionals. Nevertheless, if one catheter doesn’t work there may be others that the man can try. David was initially given a catheter with a tap on it to control his urination; this didn’t work for him so he was given a different type of catheter that drained his urine into a bag. Jim also struggled with his catheter at first.
The main times that men had to use catheters were when they were in hospital having surgery and for a short period when they returned home after the operation. To have the catheter taken out, the men had to go in to the specialist penile cancer centre.
Some men found having a catheter awkward or uncomfortable. Others talked about using a catheter being embarrassing, particularly if they were using it after they had been discharged home from hospital after the operation. Mick said he didn’t want to go out in public with his catheter, so he had other people do his shopping. Big D had a catheter in for a week and found it difficult to manage, particularly at night. He coped with the assistance of his partner.
At the appointment where the catheter was removed, the men we interviewed had to demonstrate that they were capable of urinating unaided before being allowed home. For some, this meant drinking copious amounts of water and waiting several hours before they felt an urge to urinate.
Difficulties with urination after treatment
Men who have had part of their penis removed to treat their cancer may experience spraying or a difficulty in directing the flow of urine. Some men said these problems were short lived while they got used to the changes or their body adapted. Others had to make permanent adaptations to the way they used the toilet. For some men, using the toilet required practice. A few men talked about having to learn how to use the toilet again, teaching themselves to how to urinate. Others talked about using urination aids or equipment to help gain greater control over their urination. Men that spray can get a small plastic funnel to help them urinate. They can get this on prescription by talking to their specialist centre or their GP. Frosty said his penis was very short at first, so he urinated into a jug to avoid making a mess on the floor. Then his penis appeared to grow longer and he was able to manage without the jug. In some cases, it may be possible to undergo further surgery to improve the flow of urine.
If a man has had a total penectomy, the urethra (the tube that carries urine from the bladder) will be redirected to a new opening in the ‘perineum’, an area behind the scrotum and in front of the anus. As a temporary measure after surgery, some men had a catheter that went straight into the bladder through the stomach or abdomen. At first, Mark had a slow flow of urine, which turned out to be caused by a kink in the diverted urethra; this was sorted out during further surgery. He was concerned about keeping the area around his new opening clean after urinating, so used cleansing wipes.
Whilst some men told us that they could urinate standing up after surgery, several men felt that it was easier to do this sitting down regardless of which type of surgery they had had; others said that they had to sit down to avoid making a mess. This meant that when away from home they, would have to use a cubicle rather than the urinals.
A number of the men we talked to told us that they had lost some control over their bladder after surgery. This meant that they would suddenly need to use the toilet, and always needed to be aware of where the nearest suitable facilities were when away from home. One man talked about having to get up several times during the night to urinate.  
Some men who don’t need to sit down to urinate may choose to use a toilet cubicle for privacy. In order to find public toilets that were private and secure, some of the men used disabled toilets. Many of these toilets can be accessed by obtaining what is called a ‘Radar toilet key’. Radar is a national scheme that gives disabled users access to thousands of locked public toilets across the country.


Last reviewed January 2015.
 

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