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Sudden increase inurination

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User
Posted 01 Mar 2023 at 09:43

My husband finished radiotherapy treatment on 3rd October 2022 and was doing well, only having to get up once or twice in the night to urinate.  Yesterday afternoon he started to feel the need to pee often, but then had difficulty and just produced a trickle. He was up 4 or 5 times in the night, and the same problems continue today.

Any advice please?

User
Posted 01 Mar 2023 at 11:25
Unlikrly to be related to his RT - see a GP and ask for him to be tested for a UTI. If he stops being able to wee at all, go to A&E
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 01 Mar 2023 at 11:27
I suggest a cytobacteriological analysis of the urine be performed (urinary tract infection?)
User
Posted 01 Mar 2023 at 14:49

This could be a urinary stricture which does happen with RT in a percentage of cases. Usually it takes a bit longer than 5 months, but it's within scope of possibility. If it is this, he'll need a referral to urology. As Lyn said, if he can't pee or is peeing so little his bladder is still full, he must go straight to A&E.

User
Posted 01 Mar 2023 at 18:16

I already had a stricture before my Salvage RT. I had a suprapubic catheter fitted before my SRT as insurance against the SRT causing my stricture to get worse.

Four months after completion of my SRT, I started passing lots of blood clots and debris and the bladder capacity was drastically reduced. I didn't notice any change in frequency because I had the catheter. It is quite rare to get my level of damage from SRT.

If you do start passing lots ot blood clots etc get help from someone who understands radiation cystitis.By the time my problem was diagnosed the bladder was beyond help. As already said, if you do start getting retention, get to A&E without delay, it is classed as a medical emergency.

Thanks Chris 

 

User
Posted 01 Mar 2023 at 19:46

I had these symptoms, it was urinary retention. Do not wait for it to get worse. If it has not got better in the ten hours since the original post go to A and E now. Do not leave until he has had a bladder scan, if they say "the scan machine is broken and he can pee a bit, just go home" do not leave until they get a working machine or put in a catheter and drain his bladder.

Dave

User
Posted 10 May 2023 at 23:34

As I said in my previous post my problems started about 4 months after salvage RT. Do you know how much he can urinate in one go. Can he hold the urine and let the urge go away.  My SRT scarred the bladder and reduced the capacity, that can increase frequency. Something could be irritating the bladder and triggering the urge to go.

In my case urology were blaming oncology and oncology were blaming urology. Don't get fobbed off and ask to see someone who actually understands radiation cystitis, even if it only to rule it out. I went out of area to see a top urologist, he took me into theatre cut into my stricture and diagnosed radiation damage straight away. By the time I was diagnosed probably a few months after the blood and clots I was beyond help. As said my level of damage only happens to less than 5 percent of SRT patients.

 

Thanks Chris 

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User
Posted 01 Mar 2023 at 11:25
Unlikrly to be related to his RT - see a GP and ask for him to be tested for a UTI. If he stops being able to wee at all, go to A&E
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 01 Mar 2023 at 11:27
I suggest a cytobacteriological analysis of the urine be performed (urinary tract infection?)
User
Posted 01 Mar 2023 at 14:49

This could be a urinary stricture which does happen with RT in a percentage of cases. Usually it takes a bit longer than 5 months, but it's within scope of possibility. If it is this, he'll need a referral to urology. As Lyn said, if he can't pee or is peeing so little his bladder is still full, he must go straight to A&E.

User
Posted 01 Mar 2023 at 18:16

I already had a stricture before my Salvage RT. I had a suprapubic catheter fitted before my SRT as insurance against the SRT causing my stricture to get worse.

Four months after completion of my SRT, I started passing lots of blood clots and debris and the bladder capacity was drastically reduced. I didn't notice any change in frequency because I had the catheter. It is quite rare to get my level of damage from SRT.

If you do start passing lots ot blood clots etc get help from someone who understands radiation cystitis.By the time my problem was diagnosed the bladder was beyond help. As already said, if you do start getting retention, get to A&E without delay, it is classed as a medical emergency.

Thanks Chris 

 

User
Posted 01 Mar 2023 at 19:46

I had these symptoms, it was urinary retention. Do not wait for it to get worse. If it has not got better in the ten hours since the original post go to A and E now. Do not leave until he has had a bladder scan, if they say "the scan machine is broken and he can pee a bit, just go home" do not leave until they get a working machine or put in a catheter and drain his bladder.

Dave

User
Posted 10 May 2023 at 21:54

Originally Posted by: Online Community Member

My husband finished radiotherapy treatment on 3rd October 2022 and was doing well, only having to get up once or twice in the night to urinate.  Yesterday afternoon he started to feel the need to pee often, but then had difficulty and just produced a trickle. He was up 4 or 5 times in the night, and the same problems continue today.

Any advice please?

 

Thanks to everyone who tried to help, but this situation has not really improved.  After the pee problem started at the beginning of March my husband drank lots more water and things improved.  Last week in April he was worse again and on 4th May he was tested for UTI but tested negative, although antibiotics were still prescribed.  
He is now peeing about every 20 minutes, very painful and difficult with little output.  He only gets up about 4 times in the night & has to pee urgently but no pain.

The urology department have today told him it must be caused by the radiation and have told him to make an appointment with his oncologist sooner than the scheduled one.

My question is, does anyone know if if this side effect can happen 5 or 6 months after  radiotherapy?

User
Posted 10 May 2023 at 23:34

As I said in my previous post my problems started about 4 months after salvage RT. Do you know how much he can urinate in one go. Can he hold the urine and let the urge go away.  My SRT scarred the bladder and reduced the capacity, that can increase frequency. Something could be irritating the bladder and triggering the urge to go.

In my case urology were blaming oncology and oncology were blaming urology. Don't get fobbed off and ask to see someone who actually understands radiation cystitis, even if it only to rule it out. I went out of area to see a top urologist, he took me into theatre cut into my stricture and diagnosed radiation damage straight away. By the time I was diagnosed probably a few months after the blood and clots I was beyond help. As said my level of damage only happens to less than 5 percent of SRT patients.

 

Thanks Chris 

User
Posted 11 May 2023 at 13:21
Is he taking Tamsulosin? This can really help with urinary issues after RT. If not, it would be worth mentioning when he gets to see someone.

Chris

User
Posted 11 May 2023 at 15:32
He is taking Tamulosin but it hasn’t helped at all. He has now been prescribed Solifenacin as well, it too soon to tell if it will help.

User
Posted 11 May 2023 at 16:22

Originally Posted by: Online Community Member
The urology department have today told him it must be caused by the radiation and have told him to make an appointment with his oncologist sooner than the scheduled one.

That may be true, but it's still urology and not oncology who need to diagnose exactly what the problem is. Has he had a bladder scan after urinating and a flexible cystoscopy?

User
Posted 11 May 2023 at 20:37
He had a scan which showed very little urine, but not a cystoscope.
 
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