Transerve colon pouch : an alternative to continent urinary diversion after pelvic irradiation

ABSTRACT

Objective Urinary diversion after pelvic irradiation is challenging. The use of irradiated bowel is mostly complicated and unsuccessful. Therefore; the use of an exclusively non-irradiated bowel segment; such as the transverse colon; is a good alternative in such situation. Patients and Methods Twenty-nine female patients who had received a high dose of irradiation underwent construction of a transverse colon reservoir as a primary form of urinary diversion. The indications were irreparable vesicovaginal fistula in 5; local recurrence of gynaecological tumors in 18 and invasive bladder carcinoma in 6 patients. They were followed up for a median of 5.6 (1-9) years. Results No pouch-related complications were observed. Hydronephrosis improved in 9 of 15 renal units that had preoperatively been dilated. Incontinence occurred in 3 patients due to an inefficient stoma that was revised; and all were continent thereafter. Conclusion The results suggest that the transverse colon reservoir in previously irradiated patients is safe and effective. It can; therefore; be recommended as the method of choice in this group of patients