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[Computed tomography features after cystectomy]

M Bassanelli1, G Gozzi

  • 1Servizio di Radiologia, Ospedale "S. Anna", Como.

La Radiologia Medica
|June 1, 1993
PubMed
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Radiologists must understand postoperative anatomy after cystectomy and urinary diversion. Computed tomography (CT) effectively distinguishes between different diversion types and evaluates the genitourinary tract post-surgery.

Area of Science:

  • Urology
  • Radiology
  • Surgical Oncology

Background:

  • Continent urinary diversions are common after cystectomy for bladder cancer.
  • Reconstruction techniques vary due to patient factors and tumor stage.
  • Radiologists need to recognize postoperative anatomy for complication detection.

Purpose of the Study:

  • To describe the typical computed tomography (CT) findings after radical cystectomy and various urinary diversions.
  • To highlight the importance of radiologist familiarity with postoperative anatomy.
  • To establish CT as a key imaging modality for post-cystectomy evaluation.

Main Methods:

  • Retrospective review of 42 patients undergoing radical cystectomy and urinary diversion between 1985-1991.
  • Four types of urinary diversion were performed: ureterocutaneostomy, ureteroileocutaneostomy, ureterosigmoidostomy, and ileal/ileocecal neobladders.

Related Experiment Videos

  • Patients underwent CT scans six months post-surgery and annually thereafter.

    • Main Results:

    • Post-cystectomy, sigmoid colon loops commonly fill the bladder space; ileal loops are less frequent.
    • CT findings clearly differentiated the four diversion types based on ureteric connections.
    • Neobladder techniques (Lebag, Padovana) showed distinct volumes and shapes.
    • Ureterointestinal anastomoses were not consistently visualized.

    Conclusions:

    • Computed tomography (CT) is the preferred imaging method for evaluating patients post-cystectomy.
    • Familiarity with diverse urinary diversion anatomy on CT is crucial for accurate interpretation.
    • CT enables comprehensive assessment of the genitourinary system after radical cystectomy.