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Augmentation Enterocystoplasty After Pelvic Radiation: A Retrospective Cohort Study
Hannah S Thomas1, Sender Herschorn2, Lucshman Raveendran3
1Division of Urology, University of Toronto, Toronto, Ontario, Canada; Department of Health Policy, Stanford University, Stanford, CA.
Urology
|January 17, 2026
Summary
Augmentation enterocystoplasty (AEC) is safe after pelvic radiation therapy (RT). While functional outcomes are generally good, patients should be informed about potential long-term risks like fistulization.
Area of Science:
- Urology
- Oncology
- Surgical Oncology
Background:
- Pelvic radiation therapy (RT) for malignancy can lead to severe bladder dysfunction.
- Augmentation enterocystoplasty (AEC) is a reconstructive option for patients with radiation-induced bladder damage.
Purpose of the Study:
- To evaluate patient characteristics, surgical techniques, and functional outcomes of AEC following pelvic RT.
- To assess short- and long-term adverse events associated with AEC post-pelvic RT.
Main Methods:
- Retrospective, single-center study of 36 patients undergoing AEC between 1994 and 2022 after pelvic RT.
- Stratification into two groups: AEC during initial surgery (Group 1) or for delayed RT complications (Group 2).
- Follow-up until October 2025, death, or loss to follow-up.
Main Results:
- 36 patients included: 10 in Group 1, 26 in Group 2. Most had ileocystoplasty and ureteric reimplantation.
- Median follow-up: 13 years (Group 1) and 5 years (Group 2). 90-day readmission rate was 33%.
- Good long-term voiding outcomes reported, particularly in Group 1. Fistulization occurred in 10% (Group 1) and 19% (Group 2).
Conclusions:
- AEC is a safe and feasible procedure for managing complications of pelvic RT.
- Patients require comprehensive counseling regarding potential short- and long-term functional outcomes, including risks of fistulization.
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