Patients undergoing chemotherapy are encouraged to drink large volumes of fluids owing to the adverse effects of chemotherapy agents and complaints of voiding difficulty, which affects not only their quality of life but also their therapeutic prognoses. Most patients with cancer are old, with lower urinary tract symptoms before and after chemotherapy. For collecting patient voiding information, a self-assessed voiding diary is a useful tool. This study aimed to describe some differential characteristics of voiding according to age and chemotherapy based on information from the voiding diary of patients with non-urological cancer who complained of voiding symptoms.

The 3-day voiding diaries of 96 patients with cancer were analyzed retrospectively by a single urologist to compare the differential characteristics of voiding according to chemotherapy and age between 2013 and 2017. All patients were referred to the urologist because of voiding difficulties, and one complete 24-hour voiding diary was analyzed, including voiding volume, frequency, intervals, and nocturia, using the International Prostate Symptom Score (IPSS) voiding questionnaire. Patients were grouped according to age (≥65 vs <65 years) and the presence of ongoing chemotherapy (chemotherapy vs non-chemotherapy group). The Wilcoxon rank-sum test and generalized estimation equation were statistically utilized to determine the intrapersonal correlation.

The overall mean age and male-to-female sex ratio were 64.7 years and 80:16 (83.3%/16.7%), respectively. The median voiding frequency (daytime/nighttime), voided volume (VV), and daytime/nighttime VV was 10 (5/4), 2015 ml, and 990/900 ml, respectively. The median voided interval was 1.6 hours (interquartile range [IQR], 0.9–2.6), and the median daytime/nighttime interval was 1.7 (IQR, 1.0–2.7) and 1.5 hours (IQR, 0.8–2.4), respectively. The remaining information is documented in Table 1.
Comparison of the groups according to age and chemotherapy revealed that the total and nighttime frequencies were significantly affected by age and that voided volume was affected by chemotherapy (p ≤ 0.05), whereas none of the IPSS items were affected by age or chemotherapy (p > 0.05; Table 2). Comparison of the chemotherapy effects within the same age subgroup revealed that the voiding characteristics of the old age group (≥65 years) were not significantly different according to chemotherapy (p > 0.05). In the young age group (<65 years), chemotherapy significantly affected voided volume (p ≤ 0.05) but not voiding frequency (p > 0.05).

The voiding problem in patients with non-urological cancer was markedly influenced by age and chemotherapy. For those patients undergoing chemotherapy, the young-aged patients were affected much more in voided volume and frequency by the volume of water intake to reduce the adverse effects of chemotherapeutic agents, whereas the voiding problem in the old-aged group was not affected in voiding frequency by the chemotherapy itself but the underlying anatomical at the lower urinary tract.

This study showed that VV and voiding frequency were affected by chemotherapy or age in patients with non-urological cancer who had voiding difficulty. Large volume intake of fluids during chemotherapy might affect voiding patterns in patients in the young age group but not in those in the old age group undergoing chemotherapy who have voiding difficulty.

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