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Bladder Problems after Childhood Cancer Treatment

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

But certain therapies can affect how the bladder works. 

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.

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.

Cancer treatments that can cause urinary problems

Urinary problems that may occur

  1. Bleeding into the bladder

    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.
    • Urgent need to urinate
    • Feeling of not being able to empty the bladder.

    Tell your health care provider if these signs and symptoms occur.

    Sometimes patients need tests to detect blood in the urine.

    This condition may occur off and on for years after cancer treatment. Most cases of hemorrhagic cystitis occur during cancer therapy. 

  2. Scarring (fibrosis of the bladder)

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

    Symptoms may include:

    • Problems emptying the bladder
    • Urine leakage
    • Blood in the urine

    Sometimes the condition does not have symptoms.

    Primary care providers may refer patients to a urologist. 

    An ultrasound may show the scar tissue. A urologist may perform a cystoscopy. A cystoscopy uses a thin, lighted tube to look inside the bladder. 

  3. Bladder cancer

    Bladder cancer as a result of cancer treatment is rare.

    Symptoms include:

    • Blood in the urine
    • Need to urinate urgently or frequently 
    • Pain over the bladder, in genital area, or in the bones (advanced cancer)

    Survivors with these symptoms should see their health care providers.

  4. Neurogenic bladder

    A neurogenic bladder is loss of bladder control due to a brain, spinal cord or nerve problem. 

Know your risks and monitor your health

Childhood cancer survivors should have physical exams every year. 

You should share a copy of your  survivorship care plan with your health care provider. A survivorship care plan includes information about your disease, treatment, and long-term health care needs. 

The plan includes details about cancer treatment, including blood transfusions. The plan also includes information about health problems that may occur because of treatment.

Report urinary symptoms to a primary care provider right away. 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 extra liquids.

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

Questions to ask about bladder late effects

  • Am I at risk for bladder late effects?
  • What screenings do I need?
  • What can I do to stay healthy?
  • Is there anything else I can do to reduce my risk?

Key points about bladder late effects

  • Most survivors of childhood cancer do not have problems with their urinary bladder because of their cancer treatment. But certain therapies can affect how the bladder works.
  • Possible urinary problems include scarring and bleeding. Bladder cancer is a rare complication.
  • Symptoms of urinary problems include blood in the urine, frequent need to urinate, problems emptying the bladder, and pain during urination.
  • Your health care provider may refer you to a urologist for treatment.

—
Reviewed: August 2023

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