Total pelvic exenteration for pelvic recurrence with complex recto-vaginal and vesicovaginal fistula after surgically treated endometrial cancer
Authors:   Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, Bacalbasa Nicolae ,   Department of Visceral Surgery, Center of Excellence in Translational Medicine, Fundeni Clinical Institute, Bucharest, Romania, Balescu Irina ,   Department of Visceral Surgery, Ponderas Academic Hospital, Bucharest, Romania, Stoica Claudia ,   Department of Anatomy, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania,   Department of Surgery, Ilfov County Emergency Hospital, Bucharest, Romania, Martac Cristina ,   Department of Anesthesiology, Fundeni Clinical Institute, Bucharest, Romania, Varlas Valentin ,   Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania,   Department of Obstetrics and Gynecology, Filantropia Clinical Hospital, Bucharest, Romania, Voichitoiu Andrei ,   Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania,   Department of Obstetrics and Gynecology, “Alessandrescu-Rusescu” National Institute of Mother and Child Care, Bucharest, Romania, Pop Lucian ,   Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania,   Department of Obstetrics and Gynecology, “Alessandrescu-Rusescu” National Institute of Mother and Child Care, Bucharest, Romania, Petrea Sorin ,   Department of Surgery, “Dr. I. Cantacuzino” Clinical Hospital, Bucharest, Romania, Vilcu Mihaela ,   Department of Surgery, “Dr. I. Cantacuzino” Clinical Hospital, Bucharest, Romania,   Department of Surgery, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, Brezean Iulian ,   Department of Surgery, “Dr. I. Cantacuzino” Clinical Hospital, Bucharest, Romania,   Department of Surgery, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
Published: June 2022

Local recurrences after surgically treated endometrial cancer with associated vesical and rectal fistula represent a particular eventuality in which the only chance for cure is represented by extended pelvic resections. The aim of the current paper is to present the case of a 62 year old patient diagnosed with a local recurrence invading the urinary bladder and the rectum leading to the development of a complex fistula involving both the urinary and digestive tract after surgically treated endometrial cancer. Although initially the patient was not submitted to pelvic radiation therapy, at the time of relapse the presence of this fistula contraindicated any kind of radiation therapy. Therefore the patient was submitted to a total pelvic exenteration with cutaneous ureterostomy and terminal left colostomy. Another particularity of the patient was the fact that she had an ureteral duplication on the right side, both ureters being functional and exteriorized in right ureterostomy. In conclusion, pelvic exenteration might be a good therapeutic alternative for pelvic recurrences with complex fistulas after surgically treated endometrial cancer.