Consensus-based recommendation for surveillance of lower urinary tract problems a

This page is part of the PanCare follow-up recommendations for surveillance of late effects. Click here, for more information on these recommendations.

Who is at risk for lower urinary tract problems?

CAYA cancer survivors treated with

  • cyclophosphamide
  • ifosfamide
  • radiotherapy to a volume exposing the bladder, including TBI
  • cystectomy
  • hysterectomy
  • pelvic surgery
  • spinal cord surgery

What lower urinary problems might occur?

  • hemorrhagic cystitis

  • bladder fibrosis
  • dysfunctional voiding
  • vesicoureteral reflux
  • neurogenic bladder
  • hydronephrosis

What surveillance modality should be used and at what frequency should it be performed?

  • A history with specific attention to urinary tract symptoms
    at least every 5 years, starting at entry into long-term follow-up

What other advice should be given?

  • CAYA cancer survivors with a cystectomy and/or enterocystoplasty should be followed up by an appropriate specialist

What should be done if abnormalities are identified?

  • Perform a urinalysis including cytology and urine culture
  • Refer to a urologist if the urinalysis results are abnormal


While PanCare strives to provide accurate and complete information that is up-to-date as of the date of publication, we acknowledge that the sequence of referral and diagnostic tests might vary according to the local and national healthcare system logistics.

It is recognised that survivors and their healthcare professionals have the final responsibility for making decisions concerning their long-term follow-up care. As such, they may choose to either adopt these recommendations or not to do so after individual informed discussion. It is good practice to document this decision.

In addition to regular surveillance, real-time awareness and prompt reporting of new symptoms and signs is essential to the early detection and timely treatment of late effects.

No warranty or representation, expressed or implied, is made concerning the accuracy, reliability, completeness, relevance, or timeliness of this information.

The PanCare materials are free to use for anyone aiming to inform about late effects and long-term survivorship care. However, no financial advantage may be achieved. All communication should reference PanCare and link to the PanCare website.

a Further recommendations regarding bladder cancer are specified in the Consensus-based recommendation for surveillance of subsequent neoplasms.