Augmentation Enterocystoplasty After Pelvic Radiation: A Retrospective Cohort Study

To describe patient characteristics, surgical techniques, short and long-term functional and adverse outcomes of AEC post-pelvic RT.

We conducted a descriptive, single-center retrospective study of patients who underwent AEC between 1994 and 2022, following pelvic RT for malignancy. Patients were stratified by the timing of AEC: during initial extirpative surgery (group one), or to treat delayed complications of RT (group two). Patients were followed until Oct 2025, death, or loss to follow-up.

There were 36 patients: 10 in group one and 26 in group two. Most patients underwent ileocystoplasty and 23 (64%) had ureteric reimplantation(s). Median follow-up post-AEC was 13 and five years for groups one and two, respectively. Overall, 90-day readmission rate was 33%, with only five patients incurring Clavien-Dindo grade three complications. At last follow-up, all group one patients voided normally. In group two, 14 voided normally, seven self-catheterized (four with continent stomas), two had indwelling catheters, and three had late cystectomies. Surgical reinterventions in group one (10%) and group two (23%) were comparable as were new or recurrent fistulae; 10% and 19% respectively. Of nine deaths recorded, seven were cancer-related, while two followed secondary cystectomies.

AEC is safe and feasible post-pelvic RT. Patients should be counseled on short and long-term functional outcomes, particularly fistulization longer term.