Urinary dysfunction after colorectal cancer treatment and its impact on quality of life – a national cross‐sectional study in women

Abstract

Aim The aim of this study was to investigate urinary dysfunction and its impact on the quality of life of colorectal cancer survivors. We also wanted to identify the risk factors for impaired urinary function. Method A national cross‐sectional study was performed including patients treated for colorectal cancer between 2001 and 2014. Patients answered questionnaires regarding urinary function and quality of life, including the International Consultation on Incontinence Questionnaire – Female Lower Urinary Tract Symptoms (ICIQ‐FLUTS), measuring filling, voiding and incontinence. Data were compared with data on demographics and treatment‐related factors from the Danish Colorectal Cancer Group (DCCG) database. Results We found that rectal cancer treatment significantly impaired urinary function compared with colon cancer treatment (filling score p = 0.003, voiding p < 0.0001, incontinence p = 0.0001). Radiotherapy was the single most influential risk factor for high filling (p = 0.0043), voiding (p < 0.0001) and incontinence (p < 0.0001) scores, whereas type of rectal resection was only significant in crude analysis. Urinary dysfunction was strongly associated with an impaired quality of life. Conclusion Urinary dysfunction is common after treatment for colorectal cancer, particularly if the treatment includes radiotherapy. All patients must be informed of the risk before cancer treatment, and functional outcome should be routinely assessed at follow‐up.

Urinary dysfunction after colorectal cancer treatment and impact on quality of life—a national cross‐sectional study in males

“…The study was conducted as a national cross-sectional questionnaire women has been addressed in a separate article [14].…”

“…Furthermore, we aimed to identify possible risk factors for the development of urinary dysfunction. Urinary function in women in the same population is described in a separate article [14].…”

Multi-Disciplinary Management in Rectal Cancer Survivorship: A Clinical Practice Review

“…The mechanism of injury leading to urinary dysfunction is thought to be secondary to nerve damage during surgical resection of rectal tumors [53]. Studies have suggested worse urinary function in patients undergoing APR compared to those undergoing LAR; however, when controlled for other risk factors, these were not statistically significant [52,54,55]. The research on the impact of radiation on urinary dysfunction in rectal cancer survivors is mixed [51,54,56].…”

“…Studies have suggested worse urinary function in patients undergoing APR compared to those undergoing LAR; however, when controlled for other risk factors, these were not statistically significant [52,54,55]. The research on the impact of radiation on urinary dysfunction in rectal cancer survivors is mixed [51,54,56]. Menopausal changes associated with chemotherapy and radiation can also lead to urinary dysfunction in women [57,58].…”

“…Several studies have explored risk factors associated with developing urinary dysfunction. Commonly identified risk factors include female sex, baseline urinary incontinence, physical inactivity, and the presence of other medical comorbidities [52,54]. This is particularly pertinent for elderly patients, who have higher rates of urinary incontinence at baseline [59].…”