How to manage Urinary incontinence after cancer treatment: Urinary incontinence is a common side effect of cancer treatments, particularly surgery and radiation therapy for prostate, bladder, or gynecologic cancers. Incontinence can have a significant impact on a person’s quality of life, causing embarrassment, isolation, and limiting their daily activities.
However, there are ways to manage urinary incontinence after cancer treatment, which can help people regain their confidence and improve their overall well-being. In this blog, we will discuss some effective strategies for managing urinary incontinence after cancer treatment.
Understanding Urinary Incontinence
Before discussing strategies for managing urinary incontinence, it is important to understand what it is and what causes it. Urinary incontinence is the involuntary leakage of urine from the bladder. It can be caused by a variety of factors, including weakened pelvic muscles, nerve damage, or an overactive bladder. Incontinence after cancer treatment is often caused by damage to the muscles and nerves that control the bladder, as well as changes in the structure of the bladder and surrounding tissues.
For Reference:- cancer.ca
Types of Urine Incontinence
There are different types of urinary incontinence, and each requires a different approach to management. The most common types of urinary incontinence after cancer treatment are –
- Stress incontinence – Stress incontinence occurs when there is pressure on the bladder, such as when coughing, sneezing, or lifting heavy objects.
- Urge incontinence – Urge incontinence is when there is a sudden and strong urge to urinate, followed by an involuntary loss of urine.
- Overflow incontinence – you will not know but there will be an involuntary loss of urine as soon as your bladder is full.
- Continuous incontinence – there will be constant urine leakage.
Causes of Urine Incontinence
There is a mechanism of urine storage and release in your body. Your bladder is like a balloon, a hollow organ. Whenever your body makes urine, the bladder enlarges to keep it in. and your bladder nerves give you a signal to urinate while your muscles of the bladder hold it till you are ready to urinate. When you are ready, the corresponding muscles relax and you pass that urine from your body. Cancer and certain treatment and ailments can cause damage to this system of yours leading to Urine Incontinence. These causes include –
- Pelvic area cancer – the pelvic area includes the reproductive organs and the bladder, therefore includes cancers such as bladder cancer, urethral cancer, prostate cancer, colorectal cancer, cervical cancer, uterine cancer, and vaginal cancer.
- Certain other cancers – cancer that affects and damages the nervous system, therefore affecting voluntary actions, such as brain and spinal cord cancer.
- Chronic coughing – due to certain diseases such as TB, lung, or oesophageal cancer exerts high pressure on your bladder. This can cause involuntary urine leakage.
- Cancer treatment – such as radiation, can make your bladder muscles sensitive, or surgery on the infected pelvic organ can damage your pelvic and bladder muscles. Chemotherapy can also cause nerve damage and therefore lead to urine incontinence. Cancer medicines can also cause you to urinate frequently, vomiting which can exert pressure on your bladder, etc.
- Low female hormone – certain treatments can cause early menopause, therefore lowering the level of hormones such as estrogen. This can cause the bladder and urethra to weaken and therefore loss of their urinary function.
Diagnosis of Urine Incontinence
Diagnosis of the same is some small tests and measures. But you will need you to tell your doctor, why you feel this way. You can maintain a ‘voiding diary’ to show your doctor. This will include the details of your urination, such as how frequently you urinate, how much, and when you urinate. When it leaks, etc. on the basis of your description, your doctor may recommend you some tests including –
- Urine test for the presence of any infection.
- To test your bladder capacity, you are made to cough hardest, when your bladder is full.
- Test to measure your bladder pressure.
- An ultrasound, to see the images of the inside of your bladder.
- A light tube attached to the camera is inserted into your body to look into your bladder, known as a cystoscopy can be used as a diagnostic test.
- Certain imaging tests such as X-rays can also be done.
Strategies for Managing Urinary Incontinence
Pelvic Floor Exercises
- One of the most effective strategies for managing urinary incontinence after cancer treatment is pelvic floor exercises.
- These exercises involve contracting and relaxing the muscles that support the bladder and urethra, which can help improve bladder control.
- Kegels, a pelvic floor exercise can also be done to tighten your bladder muscles and can be done anywhere and at any time. This is done by repetitively tightening and relaxing your bladder muscles. It is recommended to do them regularly, ideally every day, for a few minutes at a time.
- To do pelvic floor exercises, first, identify the muscles you need to contract. Imagine you are trying to stop the flow of urine or trying to hold in gas. Those are the muscles that need focus.
- Then, contract these muscles for a few seconds, and then relax them for a few seconds. Repeat this cycle 10-15 times in a row, and do it 3-4 times a day.
Bladder Training
- Bladder training involves gradually increasing the amount of time between urinating to help retrain the bladder to hold more urine.
- This strategy can be particularly helpful for people with urge incontinence.
- The goal is to increase the time between bathroom visits to at least two to three hours. Start by keeping a diary of your bathroom habits to help identify patterns and determine when you need to urinate.
- Then, gradually increase the time between bathroom visits by 15-30 minutes each week.
- Over time, your bladder will learn to hold more urine, reducing the urge to urinate and the incidence of incontinence episodes.
Fluid Management
- Managing fluid intake can also help with urinary incontinence.
- While it is important to stay hydrated, reducing fluid intake in the evening can help minimize incontinence episodes during the night.
- It is also helpful to reduce the number of citrus drinks and dairy products, especially products such as chocolate, soda, tea, vinegar, sugar, milk, curs, etc.
Medication and devices
- There are various medicines and medical devices to help prevent leakage of urine due to any medical issue.
- These include medicines such as Oxybutynin or Tolterodine, which relax the hyperactive bladder. This hyperactive bladder causes you to urinate instantly and immediately, causing urine leakage.
- Duloxetine is used to treat depression, which can also be a factor for dysfunctioning the bladder.
- Collagen is injected to thicken the bladder walls that cause leakage.
- Botulinum toxin is injected to relax bladder muscles.
- A medical device such as Pessary is worn into the vagina to support the bladder. Estrogen cream to help damage caused by menopause.
- Often in severe cases, surgery is advised to keep the bladder closed and urine passes through the urethra.
- A catheter is again a thin tube inserted into the bladder attached to a collecting bag, when a person has to urinate, the urine from the bladder gets collected into that bag outside and therefore prevents leakage.
Frequently Asked Questions
It is the leakage of urine due to dysfunctional or damaged bladder. It can happen due to various reasons such as any disorder or disease, treatment of certain ailments, due to surgery, depression or hormonal imbalance. Although it can be treated and managed well.
You can do some exercises to increase the capacity of your bladder or to improve the muscles of the bladder. Certain other methods are pads, pad-pants to absorb the leaked urine, to avoid embarrassment. Other include absorbing bed sheets to absorb urine during night, if you urinate in sleep. Cut on some drinks and foods that irritate your bladder and cause frequent urination.
If you are experiencing urinary incontinence, you should tell your health team about the frequency, color, amount, time of your urine or urination schedule and you can also write that details so that you don’t skip anything. This will help the doctors to draw some conclusion and recommend you appropriate tests and treatment, along with management tips.
Yes, it is very usual to experience such side-effects if you are dealing with pelvic or brain cancer. These can damage you nerves or muscles of bladder causing loss of function or dysfunction. Certain cancer treatment such as radiation, chemotherapy and surgery can also affect in the same way. You should recommend doctor if you are experiencing this and seek medical help.