Urinary tract infections (UTIs) commonly occur in people who undergo chemotherapy. The treatment can weaken the immune system and damage barriers, such as the skin and mucous membranes, that help prevent infection.

Chemotherapy drugs kill cancer cells to prevent them from growing and dividing into new cells. However, the therapy also kills noncancerous cells, which can lead to adverse effects. These can include UTIs and other bladder complications.

An IV tube containing chemotherapy drugs, which can increase the risk of developing a UTI.Share on Pinterest
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Chemotherapy can lead to UTIs and other infections.

UTIs are one of the most common infections in people with cancer and often occur as a result of chemotherapy. In one 2022 study, 82.6% of UTIs occurred while people were undergoing cycles of chemotherapy.

Chemotherapy may cause UTIs in different ways. These include:

  • Neutropenia: Neutropenia is a significant reduction in a type of white blood cell called neutrophils. Chemotherapy can kill neutrophils, which are vital for fighting off infection. People with low neutrophil levels are at increased risk of developing infections, such as UTIs.
  • Destruction of anatomic barriers: Anatomic barriers, such as mucous membranes and skin, provide a defense against harmful pathogens. Chemotherapy can damage these barriers and allow microorganisms that usually exist on their surfaces to enter and cause infection.

Chemotherapy can increase a person’s risk of infection and affect mucous membranes in the body. These changes can cause problems in the bladder besides UTIs.

Potential bladder problems related to chemotherapy include the following.

  • Lower urinary tract symptoms (LUTS): Older research cited in a 2022 study suggests that more than 70% of people who receive chemotherapy may experience LUTS. Chemotherapy can cause inflammation, irritation, and a higher risk of infection, which may lead to LUTS. The condition causes urinary symptoms, such as difficulty urinating, urinary incontinence, and frequent urination.
  • Cystitis: Chemotherapy can increase a person’s risk of cystitis, which is an inflammation of the bladder. Cystitis occurs due to infection in the bladder.
  • Vaginal dryness: Some chemotherapy drugs can affect the mucous membranes of the vagina, causing dryness and inflammation. This could lead to a higher risk of infection, including sexually transmitted infections (STIs), yeast infections, and UTIs.

Which chemotherapy drugs can cause urinary complications?

Several chemotherapy drugs can cause urinary complications, such as UTIs. These include:

According to the National Cancer Institute, cancer-related UTI symptoms can include:

A person may also experience symptoms of LUTS, which include:

  • urinary incontinence, or loss of bladder control
  • nocturia, or frequent nighttime urination
  • frequent urination
  • difficulty emptying the bladder
  • urinary hesitancy or straining to urinate
  • the urge to urinate even when the bladder is empty
  • sudden urges to urinate

Chemotherapy may also cause cystitis symptoms, which can include:

  • pain or burning during urination
  • urgent need to urinate
  • frequent urination
  • strong-smelling, cloudy, or dark urine
  • lower abdominal pain
  • tiredness and weakness
  • fever

Doctors may treat UTIs and bladder problems differently depending on the type, severity, and cause of the problem.

If a person has a bacterial infection, doctors will typically prescribe antibiotics.

For other types of infections, doctors may prescribe:

If a person develops bladder incontinence or other LUTS, treatment may include bladder training and pelvic therapy, which can help manage the urge to urinate and strengthen the pelvic muscles.

A doctor may also prescribe medication to help relax overactive bladder muscles or suggest a medical device, such as an external catheter.

If urinary incontinence persists, surgery may be a treatment option, depending on the cause. Types of surgery include removing obstructions, implanting an artificial urinary sphincter, and implanting a mesh sling to support the bladder and urethra.

A person should contact a doctor if they experience UTIs or bladder problems while undergoing chemotherapy. However, the following may help improve urinary problems until a person can contact their doctor:

  • keeping track of bladder habits, such as frequency of urination
  • drinking plenty of fluids
  • avoiding substances that can worsen urinary symptoms, such as caffeine, alcohol, and certain medications, including muscle relaxers
  • using incontinence products if necessary, such as disposable pads
  • keeping the genital area clean and dry

A person may also want to try the following, which may relieve symptoms:

  • applying a heated pad or hot water bottle to the abdomen to relieve pain
  • taking probiotics, which may help improve vaginal health
  • washing hands before touching genitals
  • wiping from front to back after using the bathroom

A person may be able to reduce their risk of developing a UTI by taking the following steps:

  • going to the bathroom often
  • taking showers instead of baths
  • drinking plenty of fluids
  • avoiding alcohol, caffeine, tobacco products, and spicy foods
  • practicing good catheterization hygiene and safety
  • urinating after intercourse
  • wearing loose-fitting clothing and cotton underwear
  • keeping the genital area clean

Those undergoing chemotherapy or any other cancer treatments should contact a doctor if they develop bladder-related symptoms or UTIs.

People who receive chemotherapy may be at higher risk of severe complications of infection, such as sepsis. A person should contact their cancer care team or doctor if they experience the following, which may be signs of sepsis:

  • fever or lower-than-normal body temperature
  • sweats or chills
  • clammy, cold skin
  • pain or burning during urination
  • pain in the flanks, either side of the lower back
  • not having to urinate, or urinating very little
  • brown or dark orange urine
  • confusion
  • dizziness or lightheadedness
  • trouble breathing

What is the 7-day rule in chemotherapy?

The 7-day rule in chemotherapy refers to a schedule of treatment cycles. It allows for a person to receive a high enough dose of chemotherapy drugs to kill cancer cells while also allowing some time for rest and reducing toxicity levels from the treatment within 7 days.

How can I get immediate relief from a UTI?

The fastest method of UTI treatment is treatment with an antibiotic. Applying a warm compress or heated pad to the abdomen may relieve pain until the symptoms improve.

How can I tell the difference between a UTI and a bladder infection?

Bladder infections are a type of UTI. The urinary tract includes the kidneys, ureters, urethra, and bladder.

Chemotherapy may lead to UTIs and other bladder or urinary problems. This is because the treatment kills healthy cells as well as cancer cells, which can lower a person’s resistance to infection.

Chemotherapy can also damage anatomic barriers, such as mucous membranes in the body, which can allow bacteria to infect the urinary tract.

As well as UTIs, chemotherapy can also cause lower urinary tract symptoms (LUTS), cystitis, and vaginal dryness.

A person should contact their cancer care team or doctor if they experience signs of UTIs or bladder problems. People who are receiving chemotherapy may be at higher risk of severe complications of infection, such as sepsis, which can be life threatening.