Reverse seven ileal ureteroplasty with ileocystoplasty for bilateral radiation ureteral obstruction and a contracted bladder

Bilateral ureteral obstruction after pelvic radiotherapy is uncommon, and rarer still when the bladder is also contracted, because this removes the low pressure reservoir that ureteral reconstruction depends on. A 39 year old woman developed total obstruction of both ureters and a 100 mL bladder after chemoradiotherapy for cervical cancer. One 35 cm distal ileal segment in a reverse seven configuration replaced both ureters, and its caudal limb was detubularised and anastomosed to the bivalved bladder. At six months she voided spontaneously, was continent and remained free of disease. The reconstruction was performed using an open approach.