Most people who have treatment for cancer as a young adult will not get bladder problems. Bladder problems can develop during or shortly after treatment finishes. It can also happen a long time after treatment.

Not all bladder symptoms are caused by cancer treatment. As you get older, the bladder and pelvic floor muscles naturally become weaker. Giving birth and going through the menopause can also affect these muscles.

Treatments can cause the bladder to shrink. This means it cannot hold as much urine (pee) as before. This happens when the bladder walls become scarred and the tissue becomes less stretchy.

Overactive bladder

An overactive bladder means you often suddenly feel the need to pass urine (pee). Your bladder feels full, even when there is not much in it.

 Bladder retraining means learning ways to train your bladder to hold more urine. This means you do not have to pass urine as often. It is best to do bladder retraining with expert help from a specialist.

You may be asked to complete a chart to see:

• How much you drink
• How often you go to the toilet
• How much urine you pass

It is important to keep drinking plenty of fluids, at least 1 to 2 litres (2 to 3½ pints) a day, so that your bladder learns to cope. It also helps to dilute your urine. This makes it less likely to irritate your bladder.

Bladder retraining should be done over a few weeks. You start by ‘holding on’ for a few minutes when you need to pass urine. You gradually increase this by a few minutes each time. Sitting on a hard seat might help. You may find it easier to distract yourself by reading, listening to the radio, or watching television. Your specialist might have other suggestions to distract yourself, such as counting backwards.

You only do the bladder retraining in the day. By doing this, the aim is that you will eventually need to go to the toilet less often at night.

Because the bladder is a muscle, it becomes stronger with retraining exercises. After a few weeks, you should find you need to go to the toilet less often.

If bladder retraining has not helped, your specialist might suggest other treatments.

Drugs to relax the bladder

There are drugs that can relax the bladder so it can hold more urine. These drugs can help an overactive bladder or if you leak urine (urinary incontinence). You sometimes need to take them for a while to see if they are helpful. You may need to try different ones, to find one works for you. Your doctor can tell you more.

Botulinum toxin type A (Botox)

Botox^® injections can help the symptoms of an overactive bladder. They may be used if other treatments have not helped.

The injections help to relax the bladder, meaning it can store more urine. They can also help you ‘hold on’ for longer.

The treatment can be done in the outpatient department with a local anaesthetic. Sometimes, a general anaesthetic is needed. The doctor passes a thin, flexible tube with a light on the end (a cystoscope) through your urethra and into your bladder. They then inject the Botox^® into the wall of your bladder.

You may find it difficult to pass urine after having this treatment. This is usually temporary. It may last for a few days or weeks. Before you have Botox^® injections, a nurse will show you how to empty your bladder using a thin, plastic tube (catheter). Your doctor or nurse can tell you more about this.

The effect of Botox^® usually wears off over several months. But the injections can be repeated.

Nerve stimulation

Nerve stimulation uses electrical pulses to help with bladder and bowel problems. It may be used when other treatments have not helped. Your doctor or continence adviser can explain more about it.

Urine retention – difficulty passing urine

If you are having difficulty passing urine or feel that you are not emptying your bladder completely, it is important to see your doctor. It can cause problems that are more serious if they are not treated. Your doctor or continence adviser will do tests to find out the cause so they can offer you the right treatment for your situation.

If you are having problems passing urine (peeing), or feel that you are not emptying your bladder completely, it is important to see your doctor. If urine builds up in the bladder, it can cause infections and damage the kidneys.

Your doctor or continence adviser will do tests to find out the cause so they can offer you the right treatment for your situation.