Urinary complications following Bricker urinary diversion in gynecologic cancer: A retrospective analysis of 77 cases
8 affiliations
- 1Department of Gynecologic Surgery Gustave Roussy Villejuif France
- 2Department of Urology Gustave Roussy Villejuif France
- 3Department of Radiation Oncology Gustave Roussy Villejuif France
- 4Department of Medical Oncology Gustave Roussy Villejuif France
- 5Inserm U981 Gustave Roussy Villejuif France
- 6Department of Pathology Gustave‐Roussy Villejuif France
- 7Inserm U1030 Gustave Roussy Villejuif France
- 8University Paris Saclay France
Abstract
Introduction: To evaluate postoperative urinary complications and their management in patients undergoing Bricker urinary diversion for gynecologic cancers, with a focus on identifying risk factors, especially uretero‐ileal strictures.
Material and Methods: We conducted a retrospective single‐center study of 77 patients who underwent Bricker urinary diversion for gynecologic cancers between 2000 and 2020. All surgeries were performed by the same gynecologic oncologic team.
Results: Primary tumor sites included the cervix and uterine body in 87% of patients, with others involving the vagina, vulva, and adnexa. Preoperative pelvic radiotherapy was performed in 71%, and para‐aortic/pelvic radiotherapy in 10%. Over a median follow‐up of 21 months, uretero‐ileal strictures occurred in 30%, and fistulas in 6%. Preoperative nephrostomy was significantly associated with a higher rate of strictures (p = 0.001), while preoperative ureteral stenting was associated with a reduced risk (p = 0.005). All patients with strictures or fistulas were initially managed with ureteral stenting; nephrostomy was subsequently required in 56% of stricture and 80% of fistula cases. Surgical treatment was eventually needed in 17% and 60%, respectively. Additional risk factors for strictures included preoperative chemotherapy (p = 0.023) and intraoperative evidence of chronic enteritis (p = 0.013). No significant differences were observed in overall or recurrence‐free survival between patients with and without strictures (p > 0.05).
Conclusions: Uretero‐ileal strictures occurred in 30% and fistulas in 6% of patients undergoing Bricker urinary diversion. Preoperative ureteral stenting may help reduce stricture risk, and appropriate bowel segment selection is essential to minimize complications.
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BibTeX
@article{jaafar2026urinary,
title = {{Urinary complications following Bricker urinary diversion in gynecologic cancer: A retrospective analysis of 77 cases}},
author = {Eya Jaafar and Houssein El Hajj and Amandine Maulard and Pierre André Mal and Stéphanie Scherier and Thomas Dabreteau and Kim Do and François Zaccarini and Bastien Parier and Sophie Espenel and Alexandra Leary and Patricia Pautier and Catherine Genestie and Philippe Morice and Sébastien Gouy},
journal = {Acta Obstetricia et Gynecologica Scandinavica},
year = {2026},
month = nov,
doi = {10.1111/aogs.70365},
url = {https://doi.org/10.1111/aogs.70365},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Urinary complications following Bricker urinary diversion in gynecologic cancer: A retrospective analysis of 77 cases
AU - Eya Jaafar
AU - Houssein El Hajj
AU - Amandine Maulard
AU - Pierre André Mal
AU - Stéphanie Scherier
AU - Thomas Dabreteau
AU - Kim Do
AU - François Zaccarini
AU - Bastien Parier
AU - Sophie Espenel
AU - Alexandra Leary
AU - Patricia Pautier
AU - Catherine Genestie
AU - Philippe Morice
AU - Sébastien Gouy
PY - 2026
DA - 2026/11/04
JO - Acta Obstetricia et Gynecologica Scandinavica
DO - 10.1111/aogs.70365
UR - https://doi.org/10.1111/aogs.70365
AB - Introduction: To evaluate postoperative urinary complications and their management in patients undergoing Bricker urinary diversion for gynecologic cancers, with a focus on identifying risk factors, especially uretero‐ileal strictures. Material and Methods: We conducted a retrospective single‐center study of 77 patients who underwent Bricker urinary diversion for gynecologic cancers between 2000 and 2020. All surgeries were performed by the same gynecologic oncologic team. Results: Primary tumor sites included the cervix and uterine body in 87% of patients, with others involving the vagina, vulva, and adnexa. Preoperative pelvic radiotherapy was performed in 71%, and para‐aortic/pelvic radiotherapy in 10%. Over a median follow‐up of 21 months, uretero‐ileal strictures occurred in 30%, and fistulas in 6%. Preoperative nephrostomy was significantly associated with a higher rate of strictures (p = 0.001), while preoperative ureteral stenting was associated with a reduced risk (p = 0.005). All patients with strictures or fistulas were initially managed with ureteral stenting; nephrostomy was subsequently required in 56% of stricture and 80% of fistula cases. Surgical treatment was eventually needed in 17% and 60%, respectively. Additional risk factors for strictures included preoperative chemotherapy (p = 0.023) and intraoperative evidence of chronic enteritis (p = 0.013). No significant differences were observed in overall or recurrence‐free survival between patients with and without strictures (p > 0.05). Conclusions: Uretero‐ileal strictures occurred in 30% and fistulas in 6% of patients undergoing Bricker urinary diversion. Preoperative ureteral stenting may help reduce stricture risk, and appropriate bowel segment selection is essential to minimize complications.
SN - 0001-6349
SN - 1600-0412
ER -