Yes. The caution here is that radiation to the abdomen or pelvis (i.e., for ovarian cancer, prostate cancer, lymphoma, or other cancer) makes the procedure more difficult for the surgeon and increases the risks for the patient. Radiation causes the tissues to become very stuck together.
In this situation, normal dissection during surgery is not possible, increasing the risk of injuring normal structures such as the bowel or blood vessels. Also, prior radiation therapy decreases the body’s ability to heal in those areas exposed to the radiation.
This creates a greater risk of having leaks or other complications. Because of its increased difficulty and risk, a radical cystectomy after pelvic radiation should only be performed by surgeons with experience in this area. When performed by an experienced surgeon, the overall risk is about the same as for patients who have not had prior radiation, except that the risk of incontinence will be slightly elevated.
Individuals who have had prior abdominal or pelvic irradiation are best treated with a urinary diversion made from a piece of the trans-verse colon as opposed to a segment of the small intestine. The transverse colon lies higher in the abdomen and tends to be spared during pelvic radiation therapy. The ultimate choice of the segment of intestine to be used for the urinary diversion will depend on your surgeon’s preference, the area of your prior radiation treatments, and how the intestine looks at the time of surgery.