Pelvic exenteration: complications of urinary diversion

We report complications directly related to urinary diversion among 32 patients who underwent pelvic exenteration for gynecologic malignancy. Eight patients (25 per cent) sustained 10 major complications, including 8 urinary fistulas and 2 fistulas from the entero-enterostomy sites. The frequency of these complications was greater among patients who had had total exenteration than among those who had had anterior exenteration. We attempt to identify factors responsible for these complications and discuss methods for reducing the morbidity related to urinary diversion in these patients.