부산대학교 도서관

Simple Summary: Post-radiation prostate cancer patients are at an increased risk for developing a multitude of long-term complications, notably, a nonfunctional bladder with associated fistulae, bleeding, and infection. In its advanced stages, this can be difficult for the clinician to effectively manage. Our review discusses the role of cystectomy in patients with a radiation-induced end-stage bladder and the challenges that an irradiated surgical field poses to the surgeon. In summary, the literature supports cystectomy in select patients as an option for definitive treatment, which can drastically improve the quality of life in these patients. Men with prostate cancer have the daunting task of selecting from multiple modalities of treatment. The long-term effects of radiation therapy are only now being recognized. For both patients and surgeons, the end-stage irradiated bladder poses numerous problems and challenges. Specifically, irradiated bladders with urosymphyseal fistula, radiation cystitis, and rectourethral fistula are challenging to manage and treat. This review outlines the presentation, workup, and management including cystectomy for these three devastating late complications of radiation therapy. There are special considerations when performing benign cystectomy that are not typically considered during oncologic cystectomy. We discuss an overview of the current literature regarding the "end-stage bladder" resulting from radiation therapy and the important considerations that must be acknowledged when managing these patients. It is shown that many of the less invasive and conservative options ultimately lead to cystectomy. Indeed, our review concludes that cystectomy with urinary diversion is a safe and viable option in select irradiated patients with the goal to improve quality of life. [ABSTRACT FROM AUTHOR]