What is Radiation Cystitis?

Radiation cystitis is a condition where complications of radiation therapy cause swelling and inflammation of the bladder lining, resulting in pain and a reduction in proper bladder function. It is most commonly a side effect of radiation treatment of tumors in the pelvic area such as on the prostate, cervix, and bladder. Though it is not usually serious, the condition can range in severity from temporary difficulties with urination to a rarer total cease in bladder function that may lead to death. Symptoms of radiation cystitis are not always immediate and can often appear months after radiation therapy has been completed.

The condition can be treated with medication, diet, exercise, and on rare occasions, surgery. Drugs can be used to improve the process of bladder emptying and contracting, or to relax the muscles so that the patient does not feel the need to eliminate as frequently. Irritation of the bladder can be reduced by avoiding drinks with caffeine, alcohol, or citrus fruit juice. There are also pelvic and bladder exercises which can help to tone the muscles involved in urination, thus offering better control and smoother, less painful elimination. If there is a great deal of blood present in the urine or if the patient has severe problems with the retention of urine, surgery may be necessary.

Radiation cystitis is most commonly diagnosed with a combination of urine testing and cytoscopy. Urinalysis can help the doctor to determine if white or red blood cells are in the urine, which can indicate the condition. Cytoscopy involves the use of an instrument with a light on the end to physically exam the inside of the bladder for abnormalities.

Medical professionals typically organize the symptoms of radiation cystitis into two categories: acute and either late-phase or chronic. The acute symptoms of the condition tend to arise from inflammation in the bladder due to radiation. They include an increased urgency and frequency of urination. The chronic symptoms of radiation cystitis include ulcers, fistulas, incontinence, and overall dysfunction of the bladder.

Other common symptoms of radiation cystitis include pain or a burning sensation during urination or lack of ability to adequately empty the bladder. Urine can be cloudy or contain small or large amounts of blood. There can also be urinary incontinence or frequent urination at night. Some patients have abdominal pain or pressure in the pelvis. Urine may also have an unusually unpleasant odor.