Complications of urinary diversion after pelvic exenteration for gynecological malignancy

A series of 21 patients who underwent pelvic exenteration for local advance d or recurrent gynecological malignancies and urinary diversions was retros pectively reviewed. The major disease process was carcinoma of the cervix. Early complications included sepsis with wound infection and dehiscence in 4 patients, intestinal insuffency in 2 patients. 4 urinary fistulas and 3 u reteral obstructions. Six patients had a late urinary complication of steno sis of the ureterointestinal anastomosis; stones in the urinary reservoir a nd pyelonephritis were also noted. Factors responsible for these complicati ons are identified and discussed with a view to reducing the morbidity rela ted to urinary diversion in such patients.