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[Orthotopic neobladder in a female patient after radiotherapy and anterior exenteration with ileal conduit].

OBJECTIVE
To demonstrate the viability of a neobladder created after radiotherapy, anterior pelvic exanteration and previous ileal conduit.


METHODS
We report the case of a female patient who underwent anterior pelvic exanteration, radiotherapy and ileal conduit as treatment for uterine cervix cancer. A transverse colon neobladder was performed and anastomosed to the urethral stump. It was also constructed an independent self-catheterizable conduct connected to the abdominal wall, with an adjacent segment of transverse colon using the Monti's technique. This was an alternative route for catheterization in the case of problems with the urethral anastomosis.


RESULTS
Patient achieved complete continence but requires intermittent catheterization to empty her neobladder. Upper urinary tract has remained stable. The patient presented with urethral stenosis that required periodic dilations. The catheterizable conduit presented incontinence and obstruction problems due to granuloma formation and had to be removed.


CONCLUSIONS
Undiversion with creation of a neobladder and urethral anastomosis is viable in female patient after radiotherapy. Urethral stenosis was an important complication.