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["Post-actinic pelvic disease" and the ureter: the post-actinic ureter]
Claudio Simeone1, Marco Tanello, Roberto Rosini
1Divisione Clinicizzata di Urologia, Università degli Studi di Brescia. csimeone@libero.it
Purpose:
A retrospective study was done to analyze late urological complications following curative radiotherapy of primary gynecological carcinomas.
Methods:
From 1990 to 2000, 167 patients with primary gynecological cancer treated with external radiotherapy or intracavitary applications were observed. During the follow-up, all signs, symptoms and therapy of late treatment complications were recorded.
Results:
Most patients with ureteral stenosis or obstruction required surgical correction. Most patients with bladder fistulas were best served by creation of a cutaneous urinary diversion.
Conclusion:
Ureteral complications after radiotherapy of the pelvis are rare but severe. Surgical therapy of irradiated tissues has a higher complication rate compared to surgery on non irradiated tissue. A cutaneous urinary diversion may be an acceptable and safe procedure when the bladder is definitely compromised.