Urinary Symptoms & Daily Life

It is common for patients with bladder cancer to experience symptoms related to urination.^1,2 Some of those urinary symptoms can be caused by the cancer, while others may be caused by cancer treatments.

What types of urinary symptoms can bladder cancer cause?

Between 80% to 90% of people diagnosed with bladder cancer experience the symptom of blood in the urine. Bladder cancer can also cause other urinary symptoms, called irritative bladder symptoms—in around 20% to 30% of patients. Irritative bladder symptoms include:

• Needing to urinate more frequently than usual
• Feeling pain or burning before, during, or after urinating
• Feeling the urgent need to urinate despite having a bladder that is not full
• Difficulty urinating despite a full bladder

How can bladder cancer procedures and treatments cause irritation?

Irritative bladder symptoms can also be caused by procedures used to diagnose and treat bladder cancer, especially those that involve a catheter inserted into the bladder through the urethra. Bladder cancer treatments such as intravesical chemotherapy and Bacillus Calmette-Guerin (BCG) intravesical immunotherapy can cause irritative bladder symptoms as well.

Some patients with muscle-invasive bladder cancer require surgery to remove the entire bladder, after which the surgeon typically uses reconstructive surgery to create a new way for the body to store and pass urine. One option for reconstructive surgery is called a neobladder (surgeon creates a new bladder using a piece of intestine). Patients with a neobladder may experience the symptom of urine leakage or incontinence, especially while they are recovering from surgery and adjusting to the neobladder.

How can urinary symptoms impact daily life?

Living with urinary symptoms can be challenging, because they can have a substantial impact on a patient’s daily activities.² For example, if you need to urinate frequently or feel the urgent need to urinate, you may find it embarrassing to have to excuse yourself repeatedly to use the restroom, especially in a professional or social setting. If you are socializing outside of your home, it can be stressful and difficult to have to search for a restroom in an unfamiliar place, or in situations where restrooms are hard to find, inaccessible, or crowded. If you are traveling by car or plane, needing frequent restroom trips can be particularly inconvenient.

Urine leakage or incontinence can be especially uncomfortable and embarrassing. Patients may feel self-conscious or embarrassed if they need to wear and change an underwear pad in public or professional settings, or while traveling.

Tips for dealing with urinary symptoms

There are a variety of tips and strategies that patients with urinary symptoms can use to help lessen the impact of urinary symptoms on their daily activities.^3-6

Frequent urination or urgency

To help deal with frequent urination and/or the urgent need to urinate, for example, it may be helpful to reduce the amount of drinks you consume that contain alcohol and caffeine. Some people find that reducing their intake of other possible bladder irritants can help, such as carbonated drinks, chocolate, tomatoes, acidic fruits and juices, spicy foods, and artificial sweeteners.

Pain or burning

To help relieve the symptom of pain or burning during urination, it can also be helpful to avoid drinks that contain irritants, and to drink more water to help dilute irritants that you do consume. There are some prescription and over-the-counter medications that can be used to help treat painful urination, but be sure to talk with your healthcare providers before you start taking any kind of medication for urinary symptoms.

Nighttime frequency

To help reduce the number of times you need to urinate during the night, it can help to avoid drinking fluids in the evening before you go to bed. However, you should be sure to drink enough water during the day so that you stay hydrated.

Urine leakage

If you have the urgent need to urinate and you are worried about the possibility of urine leakage, it can be tempting to rush or run to the restroom as quickly as you can. However, this can actually make the feeling of urgency worse, which can make leakage more likely. Try to walk slowly and in control if you can. Some people also find it helpful to try to relax and take a couple of slow, deep breaths when they are feeling a bit panicked about their feeling of urgency.

Incontinence

Another way to help control frequent urination, as well as urine leakage and incontinence, is to strengthen the muscles around the bladder and the urethra. Pelvic floor exercises, also called Kegel exercises, involve tightening and then relaxing the pelvic floor muscles, which are the ones that you would use to stop your stream of urine while urinating.

Start by doing a small number of repetitions, and an example Kegel exercise regimen would be to try to keep the muscles tightened for at least 3 seconds and relaxing them for 3 seconds, then increase the time to 4 seconds, then 5, and so on until you can tighten the muscles for 10 seconds at a time, and then relax them for 10 seconds. Ideally, you would work up to potentially being able to repeat these sets 10 times in a row, and you would potentially do the set of 10 repetitions three times per day.