Purpose This study aimed to clarify associations between and changes over time in lower urinary tract symptoms (LUTS) and quality of life (QOL) in cancer patients after a total prostatectomy. Methods The subjects were cancer patients who had undergone total prostatectomy and had participated in non-randomized controlled trials, cohort studies, or case-control studies with outcomes of changes over time in LUTS or QOL. Fourteen studies were included for systematic review and meta-analysis. Results Compared to preoperatively, the International Prostate Symptom Score (IPSS)—a LUTS indicator—yielded the following, 3 months after operation (MD 95% confidence interval, CI = −0.27 −2.22 to 1.68, p  = .7855), 6 months after operation (MD 95% CI = −2.12 −3.04 to −1.20, p  < .0001), and 12 months after operation (MD 95% CI = −2.27 −2.63 to −1.92, p  < .0001), demonstrating significant decrease and, therefore, improvement of symptoms after 6 months. International Prostate Symptom Score—Quality of Life (IPSS-QOL), a QOL indicator, was significantly reduced at 12 months after surgery, indicating improved QOL (MD 95% CI = −0.49 −0.87 to −0.11, p  = .0107), but there was heterogeneity between different studies ( I 2  = 89.19%). A cumulative meta-analysis showed a tendency for greater improvements in IPSS-QOL at 12 months after surgery, the older the mean age and the higher the mean pre-surgery IPSS. Factors of age, prostate volume, and pre-surgery IPSS were related to postoperative LUTS; exacerbation of both urinary incontinence and urinary tract obstruction was related to QOL. Conclusion While LUTS improves over time after total prostatectomy, it takes 6 to 12 months after surgery. As there is an association between LUTS and QOL, support to promote self-management of LUTS is important.