News & stories Ovacome Blog Bladder care after treatment From the Ovacome Magazine Summer 2019 . Urinary incontinence, when you pass urine without intending to, is a possible side effect of ovarian cancer treatment which can significantly impact women’s physical, psychological and social wellbeing. But urogynaecology expert Ellie Stewart explains it does not have to be this way. "Women often put up with having incontinence because they are embarrassed or because they do not realise that treatments are available to improve and possibly cure their symptoms." "Unfortunately, treatment for gynaecological cancers can cause bladder symptoms which were not there before treatment, or can worsen those which were." "Ovarian cancer treatment very often includes surgery to the pelvis, which can cause stress incontinence if nerves are damaged. Radiotherapy can irritate the bladder and bowel, causing problems of needing to rush to the toilet and not quite making it in time." "My role is to assess and provide advice to help improve symptoms and quality of life and to show those experiencing bladder problems that they are not facing a life of wearing incontinence pads. My job is to try and get people out of them!" "There are many simple treatments available which can be tried at home, or with a referral to a hospital help can be given by a specialist such as a women’s health physiotherapist, a continence advisor, a nurse specialist or a urogynaecologist." . Stress incontinence "Symptoms are leakage with coughing, sneezing, or exercising." "Treatments can include weight loss, fluid management and pelvic floor exercises such as those included on the squeezy app. The app costs £2.99 and when downloaded onto a mobile phone buzzes with a reminder to do the exercises regularly." "There are also more expensive intravaginal devices - IncoStress, Uresta, Impressa, Diveen - which can be helpful in preventing incontinence during problem times such as exercising." "Then there is the Elvie Trainer an internal gadget, said to give results in less than four weeks, which synchronises with a smart phone to show on screen the real-time progress you are making with its pelvic floor workouts. It can be a really good motivator and although it costs around £169, it will save you spending lots of money on pads in the long-run." . Overactive bladder "Symptoms are increased frequency of urination; urge incontinence (having to rush and maybe not making it to the toilet in time) and nocturia (needing to get up at night to pass water)." "Treatments include pelvic floor exercises, fluid advice (such as reducing caffeine, drinking 1.5 to two litres of fluid and avoiding fizzy or citrus drinks and alcohol), bladder retraining to train the bladder back into good habits by holding on and not going ‘just in case’, and medication." . Urine infections "Symptoms are pain when urinating, increased frequency and urgency when passing urine." "Treatments include antibiotics, fluid advice, such as drinking two litres of fluid a day, cranberry juice and taking a D-mannose supplement." . If you are experiencing urinary problems you can always talk to your GP or medical team for a referral to a specialist for advice. . Useful websites: www.bladderhealthuk.org www.bladderandbowelfoundation.org . • Ellie Stewart is a urogynaecology nurse specialist at West Suffolk NHS Foundation Trust. Watch her talk at our 2019 Members Day.