In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez, is joined by Dr. Carlos Martinez-Gomez to discuss TOPIC. Dr. Martinez-Gomez is an author of the Lead Article for IJGC’s January 2021 issue, “Urinary diversion after pelvic exenteration for gynecologic malignancies” (https://ijgc.bmj.com/content/early/2020/11/22/ijgc-2020-002015). Dr. Martinez-Gomez is a gynecologist oncologist at Institut Universitaire du Cancer de Toulouse, France, from 2016, where he performed the ESGO fellowship program under the supervision of Drs. Gwénaël Ferron and Alejandra Martinez. His areas of interest are immunology of cervical and ovarian neoplasms, advanced ovarian cancer, reconstructive surgery after pelvic exenteration, and surgical teaching.

Highlights:
• Pelvic exenteration is a demanding surgery requiring mastery of organ removal combined with functional reconstruction
• Pelvic exenteration should be performed in high-volume referral institutions by well-trained multidisciplinary teams
• Incontinent diversion represents a good option for unfit patients or those refusing the constraints entailed by continent diversions (self-catheterization, postoperative learning, engagement)
• Postoperative complications of both types of reconstruction are comparable, but the quality of life issues would seem to support continent diversions in young and fit patients
• Continent and non-contingent techniques should be offered to patients, with a final decision based on their preferences