IRRADIATION INJURY IN URINARY TRACT: 4 REPRESENTATIVE CASES AND DANGER IN SURGICAL REPAIR

Four representative cases of severe irradiation injury in urinary tract have been reported. In one patient who had received an intraoperative regional irradiation for bladder cancer, a Bricker's operation was successful because the damage was limited. On the contrary, external radiation can cause extensive damage in the pelvic organs. In such 3 patients, Bricker's ileal diversion, Boari's operation and ureteroneocystostomy resulted in failure because of fistula formation at the anastomotic sites. These fistulas were followed by fatal peritonitis in 2 patients. Irradiation injury may be subclinical. It can progress rapidly after surgical interventions. Preand intraoperative diagnosis of the injury and careful selection of surgical procedure are important in prevention of possible complications following surgery.