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The pelvic organs, therefore, are at risk for injury by pelvic radiation. We have reviewed our experience and that of the literature with regard to the incidence of injury associated with pelvic irradiation and give recommendations for management. The most frequent and severe complications occur in association with cystectomy performed for carcinoma of the bladder that has failed definitive radiation therapy and in association with radiotherapeutic and surgical treatment of carcinoma of the cervix. We have found an 11% incidence of bowel injury following planned integrated preoperative radiation followed by cystectomy. In our experience, bowel and urinary complications secondary to external beam radiation or<\/jats:bold><jats:sup>125<\/jats:sup><jats:bold>I brachytherapy for definitive treatment of carcinoma of the prostate are very similar. The morbidity of external beam radiation therapy has been reduced using a triple\u2010course fractionated protocol. Rectal ulceration requiring colostomy has occurred in approximately 3% of patients treated with external beam or interstitial<\/jats:bold><jats:sup>125<\/jats:sup><jats:bold>I therapy. Surgical correction of rectal fistulas using vascularized flaps has been successful after<\/jats:bold><jats:sup>125<\/jats:sup><jats:bold>I injury but has not been possible after external beam injury. Urethral complications associated with definitive external beam radiation therapy for carcinoma of the prostate are most often associated with prior transurethral resection. They can be significantly reduced by withholding initiation of therapy for 4\u20136 weeks after completion of transurethral resection<\/jats:bold>.<\/jats:p>","DOI":"10.1007\/bf01658142","type":"journal-article","created":{"date-parts":[[2005,5,8]],"date-time":"2005-05-08T12:31:56Z","timestamp":1115555516000},"page":"259-268","source":"Crossref","is-referenced-by-count":36,"title":["Pelvic complications after interstitial and external beam irradiation of urologic and gynecologic malignancy"],"prefix":"10.1002","volume":"10","author":[{"given":"Paul F.","family":"Schellhammer","sequence":"first","affiliation":[{"name":"Departments of Urology and Radiation Oncology and Biophysics Eastern Virginia Medical School Norfolk Virginia USA"},{"name":"Hague Medical Center Suite 100, 400 West Brambleton Avenue 23510 Norfolk Virginia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerald H.","family":"Jordan","sequence":"additional","affiliation":[{"name":"Departments of Urology and Radiation Oncology and Biophysics Eastern Virginia Medical School Norfolk Virginia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anas M.","family":"El\u2010Mahdi","sequence":"additional","affiliation":[{"name":"Departments of Urology and Radiation Oncology and Biophysics Eastern Virginia Medical School Norfolk Virginia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[1986,4]]},"reference":[{"key":"e_1_2_1_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19850501)55:9 <2037::AID-CNCR2820551403>3.0.CO;2-L"},{"key":"e_1_2_1_3_1","volume-title":"1985 Cancer Facts and Figures","year":"1985"},{"key":"e_1_2_1_4_1","volume-title":"1980 Cancer Facts and Figures","year":"1979"},{"key":"e_1_2_1_5_1","volume-title":"End Results in Cancer, report no. 4","year":"1972"},{"key":"e_1_2_1_6_1","first-page":"19","volume-title":"Modern Concepts of Gynecologic Oncology","author":"Barber H.R.K.","year":"1982"},{"key":"e_1_2_1_7_1","volume-title":"The Basic Physics of Radiation Therapy","author":"Selman J.","year":"1960"},{"key":"e_1_2_1_8_1","volume-title":"Davis' Gynecology and Obstetrics","author":"Wharton J.T.","year":"1972"},{"key":"e_1_2_1_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000421-198308000-00017"},{"key":"e_1_2_1_10_1","volume-title":"Manual of Gynecologic Oncology","author":"Barber H.R.K.","year":"1980"},{"key":"e_1_2_1_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/0360-3016(78)90116-5"},{"key":"e_1_2_1_12_1","first-page":"67","article-title":"Dosimetric consideration in radiation therapy of carcinoma of the vagina","volume":"1","author":"Perez C.A.","year":"1976","journal-title":"Int. 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