Objective To analyze the risk factors of voiding dysfunction after laparoscopic total mesorectal resection for rectal cancer.

Methods Clinical materials of 92 patients with rectal cancer from October 2018 to October 2022 were retrospectively analyzed, and they were randomly divided into training set (n=69) and validation set (n=23). According to the residual urine volume of bladder after operation, the patients in the training set were further divided into voiding dysfunction group (n=22) and normal urinary function group (n=47). Clinical materials of patients were compared between the voiding dysfunction group and the normal urinary function group; the multivariate Logistic regression model was used to analyze the influencing factors of postoperative voiding dysfunction in patients. A Nomogram model was established, and the receiver operating characteristic (ROC) curve and calibration curve were used to validate the effectiveness of the model. A risk stratification system was established, and the differentiation of the risk stratification system in different surgical methods was verified.

Results Gender, age, presence or absence of diabetes, presence or absence of preoperative radiotherapy, tumor location, the number of removed lymph nodes, condition of pelvic autonomic nerve damage and operation mode were the independent risk factors of postoperative voiding dysfunction (P < 0.05). The ROC curves of the training set and validation set the area under the curve (AUC) was 0.843 in the training set and 0.801 in the validation set) and calibration curvesthe consistency index (C-index) was 0.896 in the training set and 0.874 in the validation set showed that the Nomogram model had good discrimination power and accuracy. The risk stratification system had a good discrimination power.

Conclusion Gender, age, presence or absence of diabetes, presence or absence of preoperative radiotherapy, tumor location, number of removed lymph nodes, condition of pelvic autonomic nerve damage and operation mode are the influencing factors of voiding dysfunction after laparoscopic total mesorectal resection for rectal cancer.