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Urinary Function After Laparoscopic Surgery in Very Low Rectal Cancer.
Yosuke Fukunaga1,2, Yuichiro Tsukada3, Takashi Akiyoshi1
1Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation of Cancer Research, Tokyo, Japan.
Diseases of the Colon and Rectum
|March 23, 2026
Summary
Laparoscopic rectal surgery can lead to urinary dysfunction, particularly in older patients and those undergoing abdominoperineal resection. Urinary function may not recover over time in these specific groups after surgery for early low rectal cancer.
Area of Science:
- Urology
- Surgical Oncology
- Gastroenterology
Background:
- Limited data exists on long-term urinary function following laparoscopic rectal surgery.
- Assessing urinary function is crucial for patient outcomes after rectal cancer treatment.
Purpose of the Study:
- To prospectively evaluate urinary function after laparoscopic low rectal cancer surgery.
- Utilize validated questionnaires to assess urinary disorders in a large cohort.
Main Methods:
- Prospective clinical phase II trial across 47 Japanese hospitals.
- 300 patients undergoing laparoscopic low rectal cancer surgery.
- Postoperative assessment of residual urine and validated urinary function questionnaires (IPSS, OABSS, ICIQ-SF).
Main Results:
- Short-term voiding dysfunction observed in 78 patients, linked to surgery duration.
- Abdominoperineal resection and age >75 years significantly impacted International Prostate Symptom Score (IPSS) post-surgery.
- Urinary function did not recover over time in patients who underwent abdominoperineal resection; older patients (>75 years) showed worse IPSS outcomes.
Conclusions:
- Laparoscopic surgery for early low rectal cancer can cause urinary function deterioration.
- Abdominoperineal resection and advanced age are significant risk factors for post-surgical urinary dysfunction.
- Further research needed to explore long-term urinary outcomes and management strategies.
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