Introduction/Background*Surgery on a radiated pelvis is a challenge for the surgeon due to the scar tissue and loss of anatomical spaces.

After radical surgery it is sometimes necessary to perform a bypass urinary tract, via an ileal conduit, known as Bricker, a continent reservoir or the creation of an orthotopic bladder.

Methodology We are describing the case of a 45 year old pacient, affected of stage IB1 cervical cancer

Wertheim Meigs hysterectomy+ bilateral salpingectomy + selective sentinel lymph node biopsy was performed in another center, followed by chemo-radiotherapy and brachytherapy.

Recurrence is detected at 9 months, describing an implant in right hemipelvis in contact with external iliac vein and bladder wall that compromises the right ureter, conditioning hydronephrosis, mesenteric implant and iliac and inguinal lymphadenopathy.

Months later a vesico-vaginal fistula was observed, and she was referred to our center.

There were not intraoperative complications Orthotopic ileas reconstruction is a complex technique, but it allows a more anatomical reconstruction, avoids the creation of stoma with less impact on the quality of life. It requires integrity of the sphincter and bladder neck and should be assessed and discussed thoroughly with the patient against other possibilities.

Conclusion*It is essential to balance the radicality of the best surgical result with the least posible impact on quality of life

Our next goal shoud be to obtain the best oncological results and survival with the minimum complications and consequences for our patients.