Complications of urinary diversion after pelvic exenteration for gynecological malignancy

A series of 21 patients who underwent pelvic exenteration for local advanced or recurrent gynecological malignancies and urinary diversions was retrospectively reviewed. The major disease process was carcinoma of the cervix. Early complications included sepsis with wound infection and dehiscence in 4 patients, intestinal insuffency in 2 patients, 4 urinary fistulas and 3 ureteral obstructions. Six patients had a late urinary complication of stenosis of the ureterointestinal anastomosis; stones in the urinary reservoir and pyelonephritis were also noted. Factors responsible for these complications are identified and discussed with a view to reducing the morbidity related to urinary diversion in such patients.