title: Orthotopic urinary diversion is a viable option in patients undergoing salvage cystoprostatectomy for recurrent prostate cancer after definitive radiation therapy.
abstract: OBJECTIVE
  To evaluate whether orthotopic urinary diversion is a viable option for patients undergoing cystoprostatectomy for radio-recurrent prostate cancer (RRPC).
  
  
  METHODS
  Between 1990 and 1996, we performed 34 salvage surgeries for RRPC, including 26 radical retropubic prostatectomies and 8 cystoprostatectomies. We determined the operative and postoperative complication rates and pathologic stage for the 8 patients undergoing cystoprostatectomy.
  
  
  RESULTS
  Of the 8 patients in whom cystoprostatectomy was performed, 5 underwent ileal conduit diversion and 3 underwent orthotopic neobladder reconstruction. There were no intraoperative complications or perioperative mortalities. In the group with orthotopic neobladder, postoperative complications included pyelonephritis in 1 patient and prolonged ileus in another. In the group with ileal conduit, no short-term complications occurred; 1 patient developed an incisional hernia on long-term follow-up. All patients with neobladder reconstruction are continent during the day. One patient wears one pad at night. The other 2 are continent at night.
  
  
  CONCLUSIONS
  Orthotopic urinary diversion is a valid option for selected patients with RRPC who require a cystoprostatectomy. This procedure can be performed with minimal complications, resulting in good continence and good quality of life.
authors.affiliation: Department of Urology, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan 48201, USA.
authors.forename: E L
authors.initials: EL
authors.lastname: Gheiler
authors.forename: D P
authors.initials: DP
authors.lastname: Wood
authors.forename: J E
authors.initials: JE
authors.lastname: Montie
authors.forename: J E
authors.initials: JE
authors.lastname: Pontes
mesh_terms: D000368:Aged; D015653:Cystectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D014547:Urinary Diversion