Urinary diversion in gynecologic oncology

Urinary diversion is a necessary part of any radical pelvic procedure that includes cystectomy. In gynecologic oncology, most situations that require urinary diversion are a result of pelvic exenterative procedures for recurrent cervical cancer or for complications of therapy (surgical or radio therapeutic), such as large or recurrent vesicovaginal fistulas. Procedures available to the pelvic surgeon range from incontinent small bowel conduits to complex continent reservoirs. The use of the Miami pouch (continent ileocolonic reservoir) has helped improve the quality of life and self-image of patients undergoing ultraradical procedures or those with significant complications of therapy necessitating urinary diversion, with acceptable morbidity.