For people who had been treated for prostate cancer, colorectal cancer, cervical cancer or penile cancer, having surgery or radiotherapy to the pelvic area can cause problems with urinating. For instance, men with prostate cancer may experience urinary incontinence after surgery. In prostate cancer the condition itself can also cause bladder control difficulties. In most people treated for cancer their urinary problems are temporary, but some of the people we spoke with were still affected five years or more afterwards.
The most common urinary problem mentioned by people we spoke with was needing to go to the toilet more often than normal. The need to go frequently varied depending on what activities people had been doing and on what and how much they had been drinking. Some said it only occurred during the night, some only in the morning, and others didn’t specify when it happened. The need to go to the toilet often was sometimes accompanied by a sensation that they had not fully emptied their bladder on each occasion, and so the needed to go again within a relatively short space of time.
Other people said they often experienced a sudden urge to pass urine which they couldn’t ignore. This problem could limit their social lives because they needed quick access to a toilet at all times and to know where they could find facilities when out and about.
Other, more unusual bladder problems also occurred. For instance, after having part of her
gut removed because of colorectal cancer, Jennie has been left with a lot of problems including a prolapsed bladder, which she empties via a catheter inserted through her abdomen. She said, ‘I’d rather not have it but, you know, I do live a normal and active life, so it’s not too bad’.
Men treated for penile cancer may also be left with long-term changes in the way they use the toilet. Penile cancer is rare but when it occurs the most common treatment is surgery. The extent of surgery depends on the size and location of the tumour; reconstruction surgery is sometimes possible. Most men need to have only part of their penis taken away but in a few cases the whole penis is removed (total penectomy) and the tube that carries urine from the bladder (urethra) is rerouted via a new opening behind the scrotum and in front of the anus.
Men who have had
penile surgery may have difficulty controlling the stream of urine, causing them to spray outside the toilet or urinal. Some men we spoke to said they could no longer use a urinal and had to sit on a toilet to urinate. Barry said he had to sit down because he urinates from a different place since his total penectomy.
Some men were offered help to overcome problems associated with spraying when urinating. Others said they had successfully retrained themselves to accurately control the flow of urine.
One woman was left with urinary incontinence for a short while after
radiotherapy for cervical cancer but successfully used pelvic floor exercises to strengthen the muscles that controlled her bladder. Another woman said that nerve damage from a hysterectomy meant she no longer had the normal sensations that indicate a need to urinate; she retrained herself using reminders.