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Bladder Late Effects

Most survivors of childhood cancer do not experience problems with their urinary bladder because of their cancer treatment.

But certain therapies can affect how the bladder functions.

How the urinary bladder works

  • The urinary bladder is the organ that stores the body’s urine.
  • The kidneys remove waste from the blood and make urine.
  • The urine travels through tubes called the ureters to the bladder.
  • Then urine leaves the body through the urethra.
Medical illustration of urinary tract anatomy

The kidneys remove waste from the blood and make urine. The urine travels through tubes called the ureters to the bladder. Then urine leaves the body through the urethra.

Cancer treatments that can cause urinary problems

Urinary problems that may occur

  1. Bleeding into the bladder (hemorrhagic cystitis)

    Bleeding into the bladder (hemorrhagic cystitis) occurs when bladder irritation results in blood in the urine.

    Signs and symptoms include:

    • Urine color that is light pink to bright red.
    • Some people may feel an urgent need to urinate.
    • Some may feel like they can’t eliminate all the urine in their bladder.
    • There is usually no pain.

    Patients should tell their health care provider when these signs and symptoms occur.

    Sometimes tests are necessary to detect blood in the urine.

    This condition may occur off and on for years after cancer treatment. Most episodes of hemorrhagic cystitis occur during cancer therapy. But it may also become a chronic problem.

  2. Scarring (fibrosis of the bladder)

    Bladder fibrosis is scar tissue in the bladder. Scar tissue may build up and cause the bladder walls to thicken. The pressure inside the bladder can increase and affect its ability to store and empty urine.

    Symptoms may include:

    • Difficulty emptying the bladder
    • Leakage of urine
    • Blood in the urine

    Sometimes the condition does not have symptoms.

    Primary care providers may refer patients to an urologist if they have symptoms of bladder fibrosis.

    An ultrasound may show the scar tissue. An urologist may perform a cystoscopy. It allows the doctor to look directly in the bladder with a thin, lighted tube.

  3. Bladder cancer

    Bladder cancer as a result of cancer treatment is rare.

    The most common symptom is blood in the urine. Patients may also experience a need to urinate urgently or frequently. Symptoms of advanced cancer are pain over the bladder, in genital area, or in the bones.

    Survivors with these symptoms should see their health care provider.

  4. Neurogenic bladder

Know your risks and monitor your health

Childhood cancer survivors should have annual physical examinations. They should share a copy of their Survivorship Care Plan with their physician. The plan includes details about your cancer treatment, including blood transfusions, and information about health problems that may occur because of your treatment.

Report urinary symptoms immediately to a primary care provider. These symptoms include:

  • Blood in the urine (pink or red urine)
  • Frequent urination or urge to urinate
  • Trouble urinating
  • Incomplete emptying of bladder
  • Pain during urination

The provider may perform urine tests to examine the urine and check for infection.

Drinking extra fluids can help flush out the bladder. But if you have kidney or heart problems, check with your physician before drinking additional liquids.

Avoid coffee, tea, cola drinks, and other drinks with caffeine.

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Reviewed: December 2019

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