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Pelvic radiotherapy side effects: bladder irritation and pain

The pelvic area is the area between the hipbones (the lower part of the abdomen). Having radiotherapy treatment in that area may affect the bladder.

Bladder inflammation (cystitis)

Inflammation of the bladder (cystitis) can develop during radiotherapy to your pelvic area. The bladder inflammation can cause the following symptoms:

  • a burning feeling or pain when you pass urine
  • a feeling that you need to pass urine more often than usual
  • a feeling that you haven't finished passing urine when you have
  • you feel as though you need to pass urine again as soon as you've been

You might also get an infection in your urine, which can make your urine look cloudy or smell strongly. Tell your doctor or nurse if you have any of the above effects. Medicines can help to reduce the cystitis. If you have an infection, you will need antibiotic treatment.

Bladder inflammation treatment

You can help to reduce the effects of cystitis by:

  • increasing the amount of fluids you drink
  • avoiding strong coffee, tea and alcohol – they can irritate your bladder and make the symptoms worse
  • asking your radiotherapy doctor or specialist nurse for medicines to increase urine flow
  • drinking cranberry juice, but ask your doctor or pharmacist first as it can interact with some medicines

Blood in the urine

Radiotherapy to your pelvic area can make the blood vessels in the bladder more fragile. This might cause bleeding some time after the radiotherapy treatment ends. 

You may see small amounts of blood or tiny blood clots in your urine. It is important to tell your doctor if this happens. You will have a cystoscopy. If the radiation damage to the walls of the bladder is only slight or occasional, you don't need to have any treatment.

If the bleeding happens often, or is heavy, you may need treatment such as tranexamic acid tablets or sealing the blood vessels with a heat probe (cauterisation). 

Your doctor can refer you to a bladder specialist (urologist) for advice about treatment.

'Just can’t wait' card

You can get a card if you want to go to the toilet more often, or feel that you can’t wait when you do want to go. You can show the card to staff in shops or pubs etc. It allows you to use their toilets, without them asking awkward questions. 

You can get the cards from Disability Rights UK or the Bladder and Bowel Foundation. They also have a map of all the public toilets in the UK. Disability Rights UK can also give you a key for disabled access toilets so that you don't have to ask for a key when you are out.

Leaking urine (incontinence)

After radiotherapy to the pelvic area, you may find that you leak a little bit of urine sometimes. The chance of leakage depends on the type of cancer and the dose of radiotherapy.

You may find that you only leak urine when you laugh, sneeze or exercise. The leakage may be due to the radiotherapy weakening the valve and muscles that keep the bladder closed. 

There are ways of making the valve and muscles stronger. These include pelvic floor exercises and medicines known as antimuscarines. Your doctor can prescribe these medicines for you.

A physiotherapist or community continence adviser can give you advice and information about dealing with urine leakage. You can get details of your nearest continence clinic or adviser from the Bladder and Bowel Foundation.

Last reviewed: 
22 Mar 2016
  • De Vita, Hellman, and Rosenberg's Cancer: Principles and Practice of Oncology (9th edition)
    De Vita, V.T., Lawrence, T.S. and Rosenberg S.A.
    Lippincott, Williams and Wilkins, 2011

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