Pelvic Extirpative Surgery for the "End-Stage Irradiated Bladder"
Nikolas Moring1, Seamus Barrett1, Andrew C Peterson2
1Department of Urology, Albany Medical Center, Albany, NY 12208, USA.
Cancers
|September 9, 2023
Summary
Managing the late effects of radiation therapy for prostate cancer can be challenging. This review details complications like fistulas and radiation cystitis, concluding that cystectomy with urinary diversion can improve quality of life for select patients.
Area of Science:
- Urology
- Radiation Oncology
Background:
- Radiation therapy for prostate cancer can lead to severe long-term bladder complications.
- These complications, including fistulas and radiation cystitis, present significant management challenges for patients and clinicians.
Purpose of the Study:
- To review the presentation, workup, and management of late radiation-induced bladder complications.
- To highlight special considerations for benign cystectomy in irradiated bladders.
Main Methods:
- Literature review of "end-stage bladder" complications following radiation therapy.
- Analysis of current management strategies, including cystectomy and urinary diversion.
Main Results:
- Urosymphyseal fistula, radiation cystitis, and rectourethral fistula are common and difficult-to-treat complications.
- Conservative treatments often fail, ultimately necessitating cystectomy.
Conclusions:
- Cystectomy with urinary diversion is a safe and effective option for select patients with end-stage irradiated bladders.
- Careful consideration of patient-specific factors is crucial for successful management and improved quality of life.
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