Vaginal recurrence after cystectomy for bladder cancer.

The records of 14 patients with vaginal recurrence following cystectomy were reviewed in an attempt to find factors responsible for the local failure. Comparison was made with female patients who underwent cystectomy for bladder cancer during the same period but who did not have vaginal recurrence. Patients with previous surgery and radiation to the pelvic organs appear to be at risk for local recurrence, probably because of the difficulties associated with surgical removal of the bladder. Patients with tumors other than transitional cell carcinoma, especially those located at the bladder neck and urethra, also appear to be at high risk. Proper surgical technique with en bloc cystourethrectomy, including excision of the anterior vaginal wall, is of paramount importance to avoid local recurrence.