CT evaluation of the pelvic cavity after cystectomy: observation in 40 cases

This study reports our experience with CT in 40 patients who underwent total cystectomies. This technique permits careful monitoring of post-operative recovery and defects and identifies complications, local recurrences, or diffuse neoplastic spread. In complete cystectomies with or without neobladder, the possibility of recognizing abnormalities depends on the operator's ability to recognize normal postoperative modifications and asymmetry in the muscle masses along the lateral walls and to identify any unusual masses. Local recurrence in the pelvic cavity can show up as alterations in the thickness of the soft structures that cover the pelvic walls or as new masses. A postoperative abscess is suggested by the demonstration of gas in a nonintestinal mass. A urinoma generally presents as a low density mass with a thin wall even if some urinomas communicate with the genitourinary tract and therefore opacify with the use of intravenous contrast medium administration. Despite these limitations, CT remains the best investigative technique for exploring the pelvic cavity after cystectomy, making it an indispensable examination in well-programmed patient follow-up.