Genitourinary distress is accidental urine leakage that can dampen underwear or saturate clothes. It is a sense of urgency, frequent urination, and/or pain or discomfort when urinating. Genitourinary distress is found in 35%–75% of patients with prostate cancer.
For genitourinary distress, standards of care are based on established evidence-based practice.
• Genitourinary distress is accidental urine leakage that can dampen underwear or saturate clothes. It is a sense of urgency, frequent urination, and/or pain or discomfort when urinating.
• Genitourinary distress is found in 35%–75% of patients with prostate cancer.
• It is also associated with hormonal changes because of endocrine therapy or menopause, radiation therapy to the pelvis, and pelvic surgery, which weakens muscles.
• Evaluate for stress, overflow, or urge incontinence.
• Perform a patient history and physical examination.
• Recommend weight loss if overweight or obese.
• Advise to avoid alcohol and caffeine as well as spicy foods and foods high in acid.
• Recommend exercises to strengthen bladder muscles (e.g., Kegel exercises).
• Suggest good toilet habits, such as scheduled toilet trips, learning to lengthen the time between urges to use the toilet, and managing fluid intake (e.g., limiting fluids to 2 L per day, reducing the intake of fluids before bedtime).
• Encourage pelvic floor muscle strengthening, ideally with a physical therapist.
• Encourage bladder training.
• Suggest medications as treatment.
• Recommend surgery as indicated.
• Suggest the use of incontinence products.
• Recommend limiting daily intake of carbonated drinks, alcohol, tea, and coffee to avoid bladder irritation.
• American Cancer Society: Bladder and bowel incontinence (https://bit.ly/3Glc7ku)
• National Institute on Aging: Urinary incontinence in older adults (www.nia.nih.gov/health/urinary-incontinence-older-adults)
Suzanne M. Mahon, DNS, RN, AOCN®, AGN-BC, FAAN, is a professor in the Department of Internal Medicine in the Division of Hematology/Oncology and in the Trudy Busch Valentine School of Nursing at Saint Louis University in Missouri and Ellen Carr, PhD, RN, AOCN®, is the editor of the Clinical Journal of Oncology Nursing at the Oncology Nursing Society in Pittsburgh, PA. The authors take full responsibility for this content. The article has been reviewed by independent peer reviewers to ensure that it is objective and free from bias. Mahon can be reached at firstname.lastname@example.org, with copy to CJONEditor@ons.org. (Submitted June 2021. Accepted August 26, 2021.)