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Lower urinary tract reconstruction with ileum in the treatment of gynecologic malignancies
John C Elkas1, Jonathan S Berek, Ronald Leuchter
1Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Walter Reed Army Medical Center, Room 6762, Building 2, 6900 Georgia Avenue NW, Washington, D.C. 20307, USA. john.elkas@na.amedd.army.mil
Introduction:
Advanced or recurrent gynecologic malignancies can invade or obstruct the lower urinary tract. If extirpation is necessary for cytoreduction or repair of radiation sequelae, treatment has typically involved creation of either an ileal conduit or a cutaneous continent urinary diversion. As an alternative, a more limited resection with urinary tract reconstruction using ileum for interposition or augmentation may allow for the preservation of urethral voiding.
Cases:
We describe the use of ileal segments for lower urinary tract reconstruction in the treatment of ten patients with advanced or recurrent gynecologic malignancies. The clinical history, surgical technique, and patient outcomes are reviewed.
Discussion:
These cases demonstrate that limited bladder or ureteral resection with reconstruction using ileal segments may offer select patients preservation of urethral voiding.
