Long-Term Urinary Dysfunction and Impact on Quality of Life After Rectal Cancer Surgery: A Prospective Multicenter Observational Study.

Background and objectives: We aimed to examine long-term changes in urinary dysfunction (UD) after rectal cancer surgery, using the three validated assessments: residual urine volume (RUV), International Prostate Symptom Score (IPSS), and International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF).

Methods: This prospective multicenter observational study was conducted in eight hospitals, and a total of 103 patients, who underwent radical resection for rectal cancer, were included. UD was evaluated at baseline and at 6, 12, and 24 months postoperatively. Quality of life (QoL) was assessed using the European Organization for Research and Treatment Cancer (EORTC) quality of life questionnaire-core 30 (QLQ-C30).

Results: The proportion of patients with UD based on RUV values decreased from 19.3% at baseline to 7.6% at 24 months (p = 0.022). However, UD, based on IPSS remained relatively constant (33.4% to 29.0%, p = 0.398), whereas UD based on ICIQ-SF score increased significantly from 17.5% to 29.0% (p = 0.019). Patients with UD, based on both IPSS and ICIQ-SF, had lower QoL scores at 24 months (mean differences -10.3; p = 0.028 and -15.4; p = 0.001, respectively), whereas RUV values showed no correlation with QoL scores after surgery.

Conclusions: RUV values gradually improved postoperatively. However, the impact of higher RUV values on long-term QoL was limited. UD, based on both IPSS and ICIQ-SF, persisted after surgery, and negatively affected long-term QoL.