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Updated: Jan 21, 2026
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Urinary dysfunction in patients with rectal cancer: a prospective cohort study.
L Karlsson1, D Bock1, D Asplund1,2
1Department of Surgery, Institute of Clinical Sciences, SSORG - Scandinavian Surgical Outcomes Research Group, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
Summary
Urinary dysfunction is common after rectal cancer treatment, with incontinence doubling 1 year post-diagnosis. Female sex and abdominoperineal excision are key risk factors for developing incontinence.
Area of Science:
- Oncology
- Urology
- Public Health
Background:
- Rectal cancer treatment frequently leads to urinary dysfunction.
- Understanding the prevalence and risk factors for urinary dysfunction is crucial for patient management.
Purpose of the Study:
- To evaluate the prevalence of patient-reported urinary dysfunction at diagnosis and 1-year follow-up.
- To identify risk factors associated with urinary incontinence after rectal cancer treatment.
Main Methods:
- Prospective cohort study (QoLiRECT) including 1085 patients at diagnosis and 916 at 1-year follow-up.
- Analysis of patient-reported outcomes via questionnaires.
- Regression analyses to determine risk factors for incontinence, with comparison to the general population.
Main Results:
- Urinary incontinence prevalence increased from baseline to 20% at 1-year follow-up (29% women, 14% men).
- Emptying difficulties (46%) and urgency (58%) were common.
- Abdominoperineal excision and baseline urinary dysfunction were independent risk factors for 1-year incontinence.
Conclusions:
- Urinary dysfunction is prevalent in rectal cancer patients, with a significant increase in symptoms one year post-diagnosis.
- Female sex, physical inactivity, comorbidity, and abdominoperineal excision are identified risk factors.
- Informing patients about potential urinary dysfunction outcomes is essential due to limited modifiable factors.
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