Inability to hold your water is a rare but distressing side effect of some cancer procedures. It can be broadly divided into two categories:
stress incontinence - referring to the complaint of urine leaking out when the individual coughs, sneezes, laughs etc.
urgency - is the situation where there is a strong desire to pass urine immediately and the individual has very little notice before he/she losses control and becomes incontinent, i.e. there is an urgent need to find a loo! This symptom is commonly experienced:
by women and is particularly seen if the uterus is enlarged, prolapsed or after pelvic surgery
by men with prostate or bladder cancer particularly following surgery such as prostatectomy or even TURP (transurethral resection of prostate)
it can also occur after pelvic radiotherapy.
If there is
a sudden onset of incontinence particularly if associated with a burning pain
– cystitis and bladder infection should be excluded or treated.
What can I do to help?
overweight try to slim down. Exercise in general has been shown to help, not
only by helping to loose weight but toning the abdominal muscles. It is
important to remember, however, that when exercising the abdominal muscles
breathe out slowly when tensing the muscles – this avoids increasing the
pressure inside the abdomen (intra-abdominal pressure) which can actually
aggravate the abdominal muscles. The most important and relevant exercise to
improve incontinence are those which strengthen the pelvic floor – pelvic
floor exercises. These exercises can also improve the muscle tone
around the anus helping piles bowel urgency or rectal prolapse. Some also
advocate pelvic floor exercises to improve sexual performance.
The level of
pelvic floor exercise depends on the individual's fitness. A general rule is to
attempt some form of exercise at least 1-2 every day and to keep it going
regularly. Benefits usually only appear within 2-3 weeks and may take several
months to peak.
Pelvic floor exercises - First of all you will need to find your pelvic floor muscles. Imagine you are trying to stop passing wind and urine at the same time. Tighten the muscles around your back passage and your front passage and lift them up inside you. When you do this you are tightening your pelvic floor muscles.
are two main types of exercise:
1 – The slow technique - Tighten the pelvic floor and count to 5,
then relax. Repeat this at
least 10 times. Perform these exercises 5 times daily.
When you feel confident with this regime increase the tightening time for
10 counts and include exercise 2 as well.
2 – The quick technique - These exercises work the muscles quickly
to help them react to sudden stresses like coughing, laughing or exercise.
Draw in the pelvic floor and hold it for just one count before letting
go. Repeat this up to 10 times.
You should aim to perform this regime of exercises 5 times daily.
You can perform these
exercises wherever you feel happy – either lying down, standing up, in the
supermarket or bus queue. On a
cautionary note, it is very easy to use other muscles as well, so be sure you
are using only the right ones, if in doubt it may be worth a referral to a
physiotherapist or personal trainer at this stage:
Do not pull in your stomach
Do not squeeze your legs together
Do not tighten your buttocks
Do not hold your breath
Further general information Your doctors and specialist nurses are in an ideal position to give you relevant information on your disease and treatment as they know your individual circumstances. Cancerbackup has a help line (0808 800 1234) and a prize winning video available in English, Italian, Urdu, Bengali, Gujarati & Hindi explaining Radiotherapy & Chemotherapy. Cancernet.co.uk has over 500 pages describing cancer, its management, practical tips and tool which patients, their carers and their doctors have found helpful during the cancer journey.