Bladder, bowel and prostate cancers can cause problems with continence and you may be experiencing bladder or bowel incontinence. This can affect many aspects of your life including personal relationships, sexual relationships, work and social issues. Following the advice below can help you improve your continence in most cases.
However, if you continue to have difficulties with your bladder or bowel control you should discuss this with your healthcare team. They can refer you to specialist pelvic health physiotherapists who can help by advising you further on pelvic floor rehabilitation and helping you to find ways to improve or regain bladder and bowel control.
Urological Cancer (kidney, bladder, prostate)
Urological cancer and its subsequent treatments can often cause problems with your bladder. What issues you may have with your bladder will depend on the type of cancer you have and if you require surgical treatment, chemotherapy or radiotherapy.
Kidney cancer may not cause too many bladder issues post operatively. You may find that you produce more or less urine or that your bladder feels like it can’t hold as much as it used to.
How bladder cancer affects your continence will very much depend on what type of cancer you have and the treatment offered for that cancer.
Prostatectomy (removal of the prostate due to cancer) is the most common cause of bladder leakage in men. Removing it can cause damage to the nerves and muscles of the bladder, urethra and /or sphincter which controls the passage of urine from the body. It is very common to experience urinary incontinence and erectile dysfunction post surgery.
Bladder problems might include:
- Passing urine more often than usual (frequency)
- A feeling that you are not able to wait when you need to pass urine (urgency)
- Leaking urine (incontinence)
- Passing urine during the night (nocturia)
- A burning feeling when you pass urine (similar to a urine infection – dysuria)
- Blood in your urine (haematuria)
- Post-micturition dribble is leakage of a few drops of urine after you have finished passing urine
General Bladder Help Information
- Follow the advice in this leaflet to ensure healthy bladder habits POGP Promoting Continence.
- Download the NHS Fife Bladder Diary to record information about your drinking and bladder habits. Or you can view a pdf version of the Bladder diary here.
- Watch this 12 minute video about How To Train Your Bladder
- Follow the 6 Week Bladder Retraining Programme from the National Association for Continence.
- Read the options available in this leaflet BAUS Overactive Bladder Treatment Options
- Find out more in the NHS Fife NHS Fife Overactive Bladder Leaflet
Pelvic Floor Exercise
Pelvic floor exercises have been proven to help reduce and cure incontinence. Find out about your pelvic floor muscles and how to strengthen them. The technique is slightly different dependent on whether you are male or female.
- NHS Fife Pelvic Floor Exercises for Men Leaflet
- Pelvic Floor Exercise Cue For Men
- There are a number of pelvic floor training apps that you can download for free or you can purchase NHS Squeezy App for Men for a small fee which is a useful visual tool and exercise reminder
- Pelvic Floor Exercises for Men POGP Leaflet
- Prostate Scotland Pelvic Floor Exercises
- NHS Fife Pelvic Floor Exercise for Women Leaflet
- Pelvic Floor Exercises For Women
- Watch these helpful videos on finding your pelvic floor muscles and doing your exercises correctly
- There are a number of pelvic floor training apps that you can download for free or you can purchase the NHS Squeezy (women) for a small fee which is a useful visual tool and exercise reminder
Your sex life and sexual function may change following your cancer and/or surgery. This will depend on the type of treatment that you have.
For men you may develop:
- erectile dysfunction (not being able to gain or maintain an erection)
- premature ejaculation (ejaculation during sexual activity sooner than you or your partner would like)
- be unable to ejaculate so your orgasms will be dry
For women you may develop:
- vaginal dryness
- dyspareunia (pelvic and/or vaginal pain during or after sex)
- bladder or bowel leakage during sex
There is a lot of evidence to suggest that pelvic floor exercises can help with sexual problems. Try the advice in the Pelvic Floor Exercises section for help with finding your pelvic floor muscles and getting started with the exercises.
If you have decided to have a prostatectomy, watch the two videos which have been produced by physiotherapists at the Western General Hospital. One focuses on what you need to know before you have the operation and the other is to be watched after your operation. NHS Fife services are slightly different so you won’t see a physiotherapist at your appointments but you can be referred to physiotherapy after the operation if you are not progressing as expected.
Colorectal Cancer (bowel or rectal cancer)
Regaining bowel control can be a challenge following treatment for bowel cancer. Your bowel habits are likely to change after you have had your treatment and you may have:
- More frequent bowel motions
- Looser stool
- Tummy pain
- A feeling that you haven’t completely emptied your bowel
- Accidental leakage of stool from the bowel or difficulty controlling wind (anal incontinence)
These problems may be worse in the first year after treatment but can carry on long term. If you have ongoing problems with bowel control you should discuss them with your healthcare provider.
Faecal Incontinence is a distressing condition which means stool leaks from the back passage. This can happen without warning or can be associated with an urge to move your bowels but being unable to make it to the toilet.
What can you do to help?
- Strengthen the muscles around the back passage by doing these Sphincter exercises
- Empty your bowel properly by sitting properly on the toilet. See the Toilet Positioning video for more information on this.
- Sometimes medication can be useful, for example, Imodium (bought over the counter) can help but you are best to discuss this with your consultant/GP/Pelvic Health Physiotherapist
- Order a Just Can't Wait card to use when out and about. This allows you quick access to toilets.
Constipation is infrequent passage of stool, with difficulty evacuating, straining and the passage of hard, lumpy stools.
What can you do to help?
- Read POGP Improving Bowel Function and NHS Fife Constipation leaflet
- Try to drink 1.5 - 2 litres of water based fluids every day.
- Try some of the dietary tips in this factsheet from the British Dietetics Association (BDA) Fibre Factsheet
- Try milled golden linseeds in your diet.
- Improve the way you sit on the toilet. This is a simple but very effective way of helping your bowels to move easily. Watch the Toilet Positioning video for more information on this.
- NICE Guideline NG123 Urinary incontinence and pelvic organ prolapse in women: management
- NICE Guideline CG148 Urinary incontinence in neurological disease: assessment and management