title: Lower urinary tract reconstruction with ileum in the treatment of gynecologic malignancies.
abstract: BACKGROUND
  Advanced or recurrent gynecologic malignancies can invade or obstruct the lower urinary tract. If extirpation is necessary for cytoreduction or repair of radiation sequelae, treatment has typically involved creation of either an ileal conduit or a cutaneous continent urinary diversion. As an alternative, a more limited resection with urinary tract reconstruction using ileum for interposition or augmentation may allow for the preservation of urethral voiding.
  
  
  METHODS
  We describe the use of ileal segments for lower urinary tract reconstruction in the treatment of ten patients with advanced or recurrent gynecologic malignancies. The clinical history, surgical technique, and patient outcomes are reviewed.
  
  
  CONCLUSIONS
  These cases demonstrate that limited bladder or ureteral resection with reconstruction using ileal segments may offer select patients preservation of urethral voiding.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Walter Reed Army Medical Center, Room 6762, Building 2, 6900 Georgia Avenue NW, Washington, D.C. 20307, USA. john.elkas@na.amedd.army.mil
authors.forename: John C
authors.initials: JC
authors.lastname: Elkas
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Berek
authors.forename: Ronald
authors.initials: R
authors.lastname: Leuchter
authors.forename: Leo D
authors.initials: LD
authors.lastname: Lagasse
authors.forename: Beth Y
authors.initials: BY
authors.lastname: Karlan
mesh_terms: D005260:Female; D005833:Genital Neoplasms, Female / Q000601:surgery*; D006801:Humans; D007082:Ileum / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D014551:Urinary Tract / Q000601:surgery*