“…To avoid the hazards of rectal injury in heavily irra diated patients, a combined abdominal and perineal approach has been advocated [1,2,4], By this method the safety and morbidity of cystectomy after high-dose radiation can be improved in men. By a staged proce dure with preliminary diversion followed by cystectomy, better results can be obtained in elderly and debilitated individuals [4].…”