Lower urinary tract dysfunction in childhood cancer survivors – A prospective study in a tertiary care hospital

Background: Lower urinary tract dysfunction (LUTD) is a potential late effect in childhood cancer survivors, often overlooked in survivorship care. Neurotoxic chemotherapy, pelvic tumors, and radiation exposure may contribute to its development. Objectives: To determine the prevalence and severity of LUTD in childhood cancer survivors and identify associated risk factors. Methods: A prospective observational study was conducted over six months among 92 childhood cancer survivors aged ≥ 5 years to 10 years. Participants were screened using the LUTD Scoring System (DVSS). A score ≥ 9 in males and ≥ 6 in females was considered diagnostic of LUTD. Clinical and treatment-related variables were extracted from medical records and analyzed for associations. Uroflowmetry and ultrasonography were performed in children with abnormal DVSS to further assess voiding pattern and bladder parameters. Results: LUTD was identified in 20 of 92 participants (21.7%), with a higher prevalence in females (31.6%) compared to males (14.8%), though this difference was not statistically significant (p = 0.073). Significant associations were observed with pelvic tumors (p = 0.002; Φ = 0.394), pelvic irradiation (p < 0.001; Φ = 0.455), Vinca alkaloid use (p = 0.035; Φ = 0.307), and high cumulative alkylating agent dose (> 8000 mg/m²) (p = 0.017; Φ = 0.267). Uroflowmetry confirmed abnormal voiding patterns in 95% of DVSS-positive patients. Most cases were managed conservatively with bladder training, while a subset required anticholinergics or laxatives. Conclusion: LUTD is prevalent among childhood cancer survivors, particularly those exposed to Vinka alkaloids and pelvic-directed therapies. Routine LUTD screening using DVSS should be integrated into long-term follow-up protocols for early detection and intervention.