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Observational Study
. 2020 Jan;22(1):18-28.
doi: 10.1111/codi.14784. Epub 2019 Aug 7.

Urinary dysfunction in patients with rectal cancer: a prospective cohort study

L Karlsson  1 , D Bock  1 , D Asplund  1   2 , B Ohlsson  3 , J Rosenberg  4 , E Angenete  1   2
Affiliations
Observational Study

Urinary dysfunction in patients with rectal cancer: a prospective cohort study

L Karlsson et al. Colorectal Dis. 2020 Jan.

Abstract

Aim: Urinary dysfunction is one of many complications after treatment for rectal cancer. The aim of this study was to evaluate the prevalence of patient-reported urinary dysfunction at the time of diagnosis and at 1-year follow-up and to assess the risk factors linked to urinary incontinence.

Method: Patients with newly diagnosed rectal cancer were included in the QoLiRECT study between 2012 and 2015. Questionnaires from the time of diagnosis and 1-year follow-up were analysed, with 1085 and 916 patients, respectively, eligible for analysis. Regression analyses were made to investigate possible risk factors for incontinence. The patient cohort was also compared with a cohort from the Swedish general population.

Results: At baseline, the prevalence of urinary dysfunction (14% of women, 8% of men) was similar to that in the general population. At 1-year follow-up, 20% of patients experienced urinary incontinence (29% of women, 14% of men). Emptying difficulties were experienced by 46% (41% of women, 49% of men) and urgency by 58% across both sexes. Abdominoperineal excision and urinary dysfunction at baseline were found to be independent risk factors for incontinence at 1-year follow-up. Among patients who were continent at baseline, risk factors were female sex, physical inactivity at baseline, comorbidity and abdominoperineal excision.

Conclusion: Urinary dysfunction is frequent among patients with rectal cancer, with up to a two-fold increase in symptoms 1 year after diagnosis. Unfortunately, few factors are modifiable and these results stress the importance of informing patients of possible outcomes related to urinary dysfunction after treatment for rectal cancer.

Keywords: PROM; Urinary dysfunction; rectal cancer.

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Conflict of interest statement

None of the authors have any conflicts of interest.

Figures

Figure 1
Figure 1
Flow chart.
Figure 2
Figure 2
Comparison of study population with Swedish reference population.
Figure 3
Figure 3
Intra‐operative and one‐year follow‐up risk factors for incontinence (bivariate analysis with urinary continence before treatment included as a fixed effect). Presented as odds ratio and 95% confidence intervals.
Figure 4
Figure 4
Subgroup of preoperatively continent patients. Baseline, intra‐operative and one‐year follow‐up risk factors for incontinence (univariate analysis). Presented as odds ratio and 95% confidence intervals.
See this image and copyright information in PMC

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