Learning objectives
- Review and systematize some reconstructive procedures associated with radical cystectomy,
focusing on the normal postoperative computed tomography (CT) imaging findings;
- Review and discuss early and late complications of these procedures.
Background
There are several causes that can lead to radical cystectomy such as: 1) neoplastic conditions - muscle-invasive bladder tumor (T2 stage or higher) or high-risk high-grade noninvasive muscle disease without metastasis; 2) benign conditions (occur less frequently) – neurogenic bladder,
damage from irradiation or interstitial cystitis/chronic inflammation.
With advanced diagnosis techniques there are an increasing number of people who are submitted to reconstructive procedures,
after radical cystectomy,
and remain in follow-up for a long period of time.
Therefore efficient imaging evaluation is essential.
CT has...
Findings and procedure details
Numerous criteria are used to select the technique including: a) age; b) physical condition; c) intestinal,
hepatic,
and renal function; d) tumor stage; e) previously abdominal radiation therapy.
There are several complex reconstructive procedures associated with radical cystectomy; in this work we will address the most commonly performed.
They can be divided according to functional result (figure 1).
The percentage of urinary diversion procedures performed are: neobladder 47%,
ileal conduit 33%,
continent cutaneous diversion 8% and incontinent cutaneous diversion 2%.
1) Incontinent diversion
1.1) Cutaneous...
Conclusion
Reconstructive procedures,
associated with radical cystectomy,
are common in the clinical practice.
Therefore,
familiarity with the normal and pathologic CT findings in patients submitted to these procedures becomes an important requisitefor every radiologist to report follow-up CTs and to avoid misdiagnosis.
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Genitourinary Radiology: Male Genital...