Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Current Bladder Dysfunction Reports
Published in: Current Bladder Dysfunction Reports 2/2016

01-06-2016 | Cancer-Associated Voiding Dysfunction (A Peterson, Section Editor)

Urinary Dysfunction in the Rectal Cancer Survivor

Authors: Brian Gilmore, Brian Ezekian, Zhifei Sun, Andrew Peterson, Christopher Mantyh

Published in: Current Bladder Dysfunction Reports | Issue 2/2016

Login to get access

Abstract

Improvements in diagnosis and treatment have resulted in significant improvement in survival rates for rectal cancer. This has led to increasing focus on post-treatment quality of life. One common sequela of treatment for rectal cancer is urinary dysfunction, defined as either difficulty voiding or incontinence. This consists of multiple clinical syndromes of distinct etiologies, most commonly dysfunction of the pelvic autonomic nerves or pelvic floor instability. This can vary in both duration and severity, with some patients experiencing transient and mild symptoms, while others experience prolonged functional impairment. A number of treatment options exist, including behavioral, pharmacologic, and surgical interventions. Because of the multifaceted nature of this process, optimal symptom relief requires careful evaluation of the severity and etiology of a patient’s complaints. Ultimately post-treatment urinary dysfunction can have a significant impact on quality of life, and it is important for clinicians to understand both the causes and management of this process.
Literature
1.
Murty M, Enker WE, Martz J. Current status of total mesorectal excision and autonomic nerve preservation in rectal cancer. Semin Surg Oncol. 2000;19(4):321–8.CrossRefPubMed
2.
Sauer R et al. Preoperative versus postoperative chemoradiotherapy for locally advanced rectal cancer: results of the German CAO/ARO/AIO-94 randomized phase III trial after a median follow-up of 11 years. J Clin Oncol. 2012;30(16):1926–33.CrossRefPubMed
3.
Vironen JH et al. Impact of functional results on quality of life after rectal cancer surgery. Dis Colon Rectum. 2006;49(5):568–78.CrossRefPubMed
4.
Varpe P et al. Quality of life after surgery for rectal cancer with special reference to pelvic floor dysfunction. Colorectal Dis. 2011;13(4):399–405.CrossRefPubMed
5.
Inoue Y, Kusunoki M. Resection of rectal cancer: a historical review. Surg Today. 2010;40(6):501–6.CrossRefPubMed
6.
Miles WE. A method of performing abdomino-perineal excision for carcinoma of the rectum and of the terminal portion of the pelvic colon (1908). CA Cancer J Clin. 1971;21(6):361–4.CrossRefPubMed
7.
Heald RJ. A new approach to rectal cancer. Br J Hosp Med. 1979;22(3):277–81.PubMed
8.
Moriya Y et al. Significance of lateral node dissection for advanced rectal carcinoma at or below the peritoneal reflection. Dis Colon Rectum. 1989;32(4):307–15.CrossRefPubMed
9.
Shirouzu K, Ogata Y, Araki Y. Oncologic and functional results of total mesorectal excision and autonomic nerve-preserving operation for advanced lower rectal cancer. Dis Colon Rectum. 2004;47(9):1442–7.CrossRefPubMed
10.
Enker WE. Potency, cure, and local control in the operative treatment of rectal cancer. Arch Surg. 1992;127(12):1396–401. discussion 1402.CrossRefPubMed
11.
12.
13.
Chang PL, Fan HA. Urodynamic studies before and/or after abdominoperineal resection of the rectum for carcinoma. J Urol. 1983;130(5):948–51.PubMed
14.
Abrams P et al. The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Urology. 2003;61(1):37–49.CrossRefPubMed
15.
Steele SR et al. The evolution of evaluation and management of urinary or fecal incontinence and pelvic organ prolapse. Curr Probl Surg. 2015;52(3):92–136.CrossRefPubMed
16.
Sterk P et al. Voiding and sexual dysfunction after deep rectal resection and total mesorectal excision: prospective study on 52 patients. Int J Colorectal Dis. 2005;20(5):423–7.CrossRefPubMed
17.
Havenga K, Enker WE. Autonomic nerve preserving total mesorectal excision. Surg Clin North Am. 2002;82(5):1009–18.CrossRefPubMed
18.
Havenga K et al. Male and female sexual and urinary function after total mesorectal excision with autonomic nerve preservation for carcinoma of the rectum. J Am Coll Surg. 1996;182(6):495–502.PubMed
19.
Pocard M et al. A prospective study of sexual and urinary function before and after total mesorectal excision with autonomic nerve preservation for rectal cancer. Surgery. 2002;131(4):368–72.CrossRefPubMed
20.
21.
Lange MM et al. Urinary dysfunction after rectal cancer treatment is mainly caused by surgery. Br J Surg. 2008;95(8):1020–8.CrossRefPubMed
22.
Duran E, et al. Urinary and sexual dysfunction rates and risk factors following rectal cancer surgery. Int J Color Dis. 2015.
23.••
Andersson J et al. Patient-reported genitourinary dysfunction after laparoscopic and open rectal cancer surgery in a randomized trial (COLOR II). Br J Surg. 2014;101(10):1272–9. The COLOR II trial provided valuable information about the epidemiology of urinary dysfunction, particularly with regard to the impact of surgical approach, but also offered large-scale patient reported data. This was particularly important due to the psychosocial importance of genitourinary function.CrossRefPubMedPubMedCentral
24.
Jayne D et al. Five‐year follow‐up of the Medical Research Council CLASICC trial of laparoscopically assisted versus open surgery for colorectal cancer. Br J Surg. 2010;97(11):1638–45.CrossRefPubMed
25.
Tekkis PP et al. Measuring sexual and urinary outcomes in women after rectal cancer excision. Dis Colon Rectum. 2009;52(1):46–54.CrossRefPubMed
26.
Junginger T, Kneist W, Heintz A. Influence of identification and preservation of pelvic autonomic nerves in rectal cancer surgery on bladder dysfunction after total mesorectal excision. Dis Colon Rectum. 2003;46(5):621–8.CrossRefPubMed
27.
Kneist W et al. Identification of pelvic autonomic nerves during partial and total mesorectal excision--influence parameters and significance for neurogenic bladder. Chirurg. 2004;75(3):276–83.CrossRefPubMed
28.
Kneist W, Heintz A, Junginger T. Intraoperative identification and neurophysiologic parameters to verify pelvic autonomic nerve function during total mesorectal excision for rectal cancer. J Am Coll Surg. 2004;198(1):59–66.CrossRefPubMed
29.
Akasu T, Sugihara K, Moriya Y. Male urinary and sexual functions after mesorectal excision alone or in combination with extended lateral pelvic lymph node dissection for rectal cancer. Ann Surg Oncol. 2009;16(10):2779–86.CrossRefPubMed
30.
Kyo K et al. Impact of autonomic nerve preservation and lateral node dissection on male urogenital function after total mesorectal excision for lower rectal cancer. World J Surg. 2006;30(6):1014–9.CrossRefPubMed
31.
Kobayashi H et al. Outcomes of surgery alone for lower rectal cancer with and without pelvic sidewall dissection. Dis Colon Rectum. 2009;52(4):567–76.CrossRefPubMed
32.
Sugihara K et al. Indication and benefit of pelvic sidewall dissection for rectal cancer. Dis Colon Rectum. 2006;49(11):1663–72.CrossRefPubMed
33.•
Sawkar HP et al. Frequency of lower urinary tract injury after gastrointestinal surgery in the nationwide inpatient sample database. Am Surg. 2014;80(12):1216–21. This study illustrated the effect of minimally invasive surgical techniques on urinary tract injury, finding a decrease in injury with laparoscopy compared with open surgery. This data further supports the increasing use of laparoscopic approaches to pelvic surgery and rectal cancer in particular.PubMed
34.
Yang L et al. Quality of life outcomes following laparoscopic total mesorectal excision for low rectal cancers: a clinical control study. Eur J Surg Oncol. 2007;33(5):575–9.CrossRefPubMed
35.
Jayne DG et al. Bladder and sexual function following resection for rectal cancer in a randomized clinical trial of laparoscopic versus open technique. Br J Surg. 2005;92(9):1124–32.CrossRefPubMed
36.
Quah HM et al. Bladder and sexual dysfunction following laparoscopically assisted and conventional open mesorectal resection for cancer. Br J Surg. 2002;89(12):1551–6.CrossRefPubMed
37.
Asoglu O et al. Impact of laparoscopic surgery on bladder and sexual function after total mesorectal excision for rectal cancer. Surg Endosc. 2009;23(2):296–303.CrossRefPubMed
38.
McGlone ER et al. Urogenital function following laparoscopic and open rectal cancer resection: a comparative study. Surg Endosc. 2012;26(9):2559–65.CrossRefPubMed
39.
Lim RS, Yang TX, Chua TC. Postoperative bladder and sexual function in patients undergoing surgery for rectal cancer: a systematic review and meta-analysis of laparoscopic versus open resection of rectal cancer. Tech Coloproctol. 2014;18(11):993–1002.CrossRefPubMed
40.
Morelli L, et al. Sexual and urinary functions after robot-assisted versus pure laparoscopic total mesorectal excision for rectal cancer. Int J Color Dis. 2015.
41.
D’Annibale A et al. Total mesorectal excision: a comparison of oncological and functional outcomes between robotic and laparoscopic surgery for rectal cancer. Surg Endosc. 2013;27(6):1887–95.CrossRefPubMed
42.
Park SY et al. Urinary and erectile function in men after total mesorectal excision by laparoscopic or robot-assisted methods for the treatment of rectal cancer: a case-matched comparison. World J Surg. 2014;38(7):1834–42.CrossRefPubMed
43.
Broholm M, Pommergaard HC, Gogenur I. Possible benefits of robot-assisted rectal cancer surgery regarding urological and sexual dysfunction: a systematic review and meta-analysis. Colorectal Dis. 2015;17(5):375–81.CrossRefPubMed
44.••
Keller DS et al. Comparative effectiveness of laparoscopic versus robot-assisted colorectal resection. Surg Endosc. 2014;28(1):212–21. With increasing scrutiny being applied to the use of robotics within colorectal surgery, this study provided important early data regarding outcomes with this approach, highlighting that the increases in cost and operative time are not offset by improved outcomes.CrossRefPubMed
45.
46.
Bernard S, et al. Effects of radiation therapy on the structure and function of the pelvic floor muscles of patients with cancer in the pelvic area: a systematic review. J Cancer Surv. 2015.
47.
Lange MM, van de Velde CJ. Urinary and sexual dysfunction after rectal cancer treatment. Nat Rev Urol. 2011;8(1):51–7.CrossRefPubMed
48.
Khandelwal C, Kistler C. Diagnosis of urinary incontinence. Am Fam Physician. 2013;87(8):543–50.PubMed
49.
Tan M, Law LS, Gan TJ. Optimizing pain management to facilitate enhanced recovery after surgery pathways. Can J Anaesth. 2015;62(2):203–18.CrossRefPubMed
50.
Kwaan MR et al. Early removal of urinary catheters after rectal surgery is associated with increased urinary retention. Dis Colon Rectum. 2015;58(4):401–5.CrossRefPubMed
51.
Lee SY et al. Risk factors and preventive measures for acute urinary retention after rectal cancer surgery. World J Surg. 2015;39(1):275–82.CrossRefPubMed
52.
Owen RM et al. Impact of surgical care improvement project inf-9 on postoperative urinary tract infections: do exemptions interfere with quality patient care? Arch Surg. 2012;147(10):946–53.CrossRefPubMed
53.
Yoo BE et al. Early removal of the urinary catheter after total or tumor-specific mesorectal excision for rectal cancer is safe. Dis Colon Rectum. 2015;58(7):686–91.CrossRefPubMed
54.
Poylin V et al. Perioperative use of tamsulosin significantly decreases rates of urinary retention in men undergoing pelvic surgery. Int J Colorectal Dis. 2015;30(9):1223–8.CrossRefPubMed
55.
Averch TD et al. AUA white paper on catheter associated urinary tract infections: definitions and significance in the urological patient. Urol Pract. 2014;2:321–8.CrossRef
56.
Qaseem A et al. Nonsurgical management of urinary incontinence in women: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2014;161(6):429–40.CrossRefPubMed
57.
Dumoulin C, Hay-Smith EJ, Mac Habee-Seguin G. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev. 2014;5:CD005654.PubMed
58.
Burgio KL. Update on behavioral and physical therapies for incontinence and overactive bladder: the role of pelvic floor muscle training. Curr Urol Rep. 2013;14(5):457–64.CrossRefPubMed
59.
Anderson CA et al. Conservative management for postprostatectomy urinary incontinence. Cochrane Database Syst Rev. 2015;1:CD001843.PubMed
60.
Glazener C et al. Urinary incontinence in men after formal one-to-one pelvic-floor muscle training following radical prostatectomy or transurethral resection of the prostate (MAPS): two parallel randomised controlled trials. Lancet. 2011;378(9788):328–37.CrossRefPubMed
61.
Shamliyan T et al. Benefits and harms of pharmacologic treatment for urinary incontinence in women: a systematic review. Ann Intern Med. 2012;156(12):861–74. W301-10.CrossRefPubMed
62.
Kaplan SA et al. Tolterodine and tamsulosin for treatment of men with lower urinary tract symptoms and overactive bladder: a randomized controlled trial. JAMA. 2006;296(19):2319–28.CrossRefPubMed
63.
Cui Y et al. The efficacy and safety of mirabegron in treating OAB: a systematic review and meta-analysis of phase III trials. Int Urol Nephrol. 2014;46(1):275–84.CrossRefPubMed
64.
65.
van Kerrebroeck PE et al. Results of sacral neuromodulation therapy for urinary voiding dysfunction: outcomes of a prospective, worldwide clinical study. J Urol. 2007;178(5):2029–34.CrossRefPubMed
66.
Siegel S et al. Results of a prospective, randomized, multicenter study evaluating sacral neuromodulation with InterStim therapy compared to standard medical therapy at 6-months in subjects with mild symptoms of overactive bladder. Neurourol Urodyn. 2015;34(3):224–30.CrossRefPubMed
67.
Laudano MA et al. Disparities in the use of sacral neuromodulation among medicare beneficiaries. J Urol. 2015;194(2):449–53.CrossRefPubMed
68.
Li J et al. The role of duloxetine in stress urinary incontinence: a systematic review and meta-analysis. Int Urol Nephrol. 2013;45(3):679–86.CrossRefPubMed
69.
70.
MacLachlan LS, Rovner ES. New treatments for incontinence. Adv Chronic Kidney Dis. 2015;22(4):279–88.CrossRefPubMed
71.
Gross C et al. Sacral neuromodulation for nonobstructive urinary retention: a meta-analysis. Female Pelvic Med Reconstr Surg. 2010;16(4):249–53.CrossRefPubMed
Metadata
Title
Urinary Dysfunction in the Rectal Cancer Survivor
Authors
Brian Gilmore
Brian Ezekian
Zhifei Sun
Andrew Peterson
Christopher Mantyh
Publication date
01-06-2016
Publisher
Springer US
Published in
Current Bladder Dysfunction Reports / Issue 2/2016
Print ISSN: 1931-7212
Electronic ISSN: 1931-7220
DOI
https://doi.org/10.1007/s11884-016-0357-4

Other articles of this Issue 2/2016

Current Bladder Dysfunction Reports 2/2016 Go to the issue

Voiding Dysfunction Evaluation (C Gomez, Section Editor)

Long-Term Urologic Evaluation Following Spinal Cord Injury

BPH-Related Voiding Dysfunction (R Lee, Section Editor)

Minimally Invasive Treatment for Male Lower Urinary Tract Symptoms: the Prostatic Urethral Lift

BPH-Related Voiding Dysfunction (R Lee, Section Editor)

Aquablation™: Early Clinical Results

Cancer-Associated Voiding Dysfunction (A Peterson, Section Editor)

Incontinence, Voiding Dysfunction, and Other Urologic Complications After Radiotherapy for Gynecologic Malignancies

Cancer-Associated Voiding Dysfunction (A Peterson, Section Editor)

Management of End-Stage Radiation Cystitis in the Cancer Survivor

BPH-Related Voiding Dysfunction (R Lee, Section Editor)

Influence of Age and Obesity on 5α-Reductase 2 Gene Expression