Total cystectomy and cutaneous uretero-ileostomy following supervoltage radiotherapy for bladder carcinoma

Cutaneous uretero-ileostomy was performed on 59 patients previously given irradiation at a dose of 6000 rads as a curative treatment. In 47 patients the urinary diversion was combined with total cystectomy. The indication for operation was residual tumour and/or subjective symptoms. It is concluded that radical surgery following super-voltage radiotherapy is possible, but implies a high lethality and severe complications. The prognosis is especially poor in patients who at the time of surgery have invasive malignant tumours. In our opinion, the operation should be done only if necessitated by severe subjective symptoms and not on the sole indication of residual tumour.