Prostate Cancer

Bowel and bladder problems

Treatments for prostate cancer such as surgery, external radiotherapy and brachytherapy may cause damage or inflammation to organs near the prostate such as the bowels and the bladder. 

Men we interviewed described episodes of bleeding from the back passage, diarrhoea, constipation and damage to the bowel after radiotherapy.

Radiotherapy sometimes results in pain and inflammation of the bladder, and a burning sensation during urination, the need to urinate more often, a sudden urge to urinate and difficulty urinating. Some men may also experience leaking urine but this is not common with radiotherapy. Brachytherapy may cause temporary urinary problems from swelling of the prostate after the insertion of the hollow needles when the seed implant is performed. Brachytherapy may also cause temporary bowel problems. 

Prostate cancer surgery can cause urinary problems if muscles or nerves are damaged. Problems include; leaking urine and difficulty urinating. One man, who had had a prostatectomy, described some urinary problems after the operation. Another man had bowel problems after he had a radical prostatectomy (bowel problems are rare after radical prostatectomy).

National Institute for Health and Care Excellence (NICE) guidelines 2014 (CG175) recommends that men “with troublesome urinary symptoms after treatment have access to specialist continence services for assessment, diagnosis and conservative treatment. This may include coping strategies, along with pelvic floor muscle re-education, bladder retraining and pharmacotherapy.” And in some extreme cases men with intractable stress incontinence should be referred to a specialist surgeon to discuss the possibility of an artificial urinary sphincter.

High Intensity focused ultrasound (HIFU) is thought to reduce bowel and bladder side effects. However bowel and bladder side effects may still occur. It is still a new treatment and more data is needed to assess its effectiveness in reducing side effects.

Last reviewed July 2017.
Last updated March 2015.



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