Kato K, et al. - A technique for modified posterior pelvic exenteration (MPPE) combined with pelvic side-wall resection requiring intestinal and urinary reconstruction is reported by researchers in this study. They quote the case of a 55-year-old woman with FIGO stage IIIC (pT3c N1 M0) ovarian cancer. She underwent an up-front cytoreductive surgery. Infiltrating the left pelvic side-wall, a tumor was suspected preoperatively; however, an enhanced computed tomography examination did not reveal hydronephrosis of the left kidney. An MPPE with pelvic side-wall resection including a partial ureterectomy was performed because of the finding of tumor involvement of the left ureter and internal iliac vessels during a laparotomy. Also, colorectal and vesicoureteral anastomoses were carried out following the resection of the pelvic and omental tumors. Findings revealed the safety as well as the feasibility of a MPPE requiring intestinal and urinary reconstruction, and this surgery can be used for patients with ovarian cancer involving the pelvic side-wall. In this patient, the bladder function after the surgery was preserved. However, the occurrence of post-surgical difficulty in spontaneous voiding and the necessity of self-intermittent catheterization was reported in some patients undergoing a MPPE combined with pelvic side-wall resection.