Chirurgische Behandlung der Strahlenschäden an der weiblichen Harnblase

Repair of late bladder injury, following x-ray or Ra therapy of uterine carcinoma, is described in 22 cases. Early surgical intervention was found to be essential in order to restore partial or complete function in the lower urinary tract. Postirradiation ulcerations of the bladder were resected and primary closure of the defect accomplished. In most cases it was possible to avoid ureterosigmoidostomy and diversion of urine flow into the intestine. Vesico- vaginal fistulae were surgically approached through the bladder with removal of all necrotic and sclerotic tissue, and closure of the bladder defect with viable tissue. Portions of bowel were used to repair large trigone defects. Diffuse bladder damage required resection and repair with bowel tissue, and regressive changes in the mesosigmoid region required replacement with small intestine. In many cases, bladder function was successfully restored.