["Post-actinic pelvic disease" and the ureter: the post-actinic ureter].

PURPOSE: A retrospective study was done to analyze late urological complications following curative radiotherapy of primary gynecological carcinomas.

METHODS

From 1990 to 2000, 167 patients with primary gynecological cancer treated with external radiotherapy or intracavitary applications were observed. During the follow-up, all signs, symptoms and therapy of late treatment complications were recorded.

RESULTS

Most patients with ureteral stenosis or obstruction required surgical correction. Most patients with bladder fistulas were best served by creation of a cutaneous urinary diversion.

CONCLUSION

Ureteral complications after radiotherapy of the pelvis are rare but severe. Surgical therapy of irradiated tissues has a higher complication rate compared to surgery on non irradiated tissue. A cutaneous urinary diversion may be an acceptable and safe procedure when the bladder is definitely compromised.