[Sigmoid carcinoma as a long-term complication following ureterosigmoidostomy]
A J Bredenoord1, M G Onaca, B van Ramshorst
1St. Antonius Ziekenhuis, Postbus 2500, 3430 EM Nieuwegein. a.bredenoord@antonius.net
Insights
Patients with ureterosigmoidostomy face a significantly higher risk of colon cancer due to urine contact with intestinal tissue. Regular colonoscopies are crucial for early detection in this high-risk group.
Area of Science:
- Urology
- Gastroenterology
- Oncology
Background:
- Congenital bladder exstrophy often requires surgical intervention, such as ureterosigmoidostomy, in infancy.
- Ureterosigmoidostomy involves rerouting the ureters into the sigmoid colon, altering urinary and fecal pathways.
Observation:
- A 45-year-old woman with a history of ureterosigmoidostomy presented with pyelonephritis.
- Colonoscopy revealed sigmoid carcinoma at the ureteral anastomosis site.
Findings:
- Individuals with ureterosigmoidostomy have a 100-fold increased risk of developing colon carcinoma compared to the general population.
- Chronic exposure of intestinal tissue to urine is implicated in the increased risk of malignant tumors following this procedure.
Implications:
- This case highlights the critical need for vigilant surveillance in patients with ureterosigmoidostomy.
- Regular colonoscopic screening is strongly advised for early detection and management of colorectal cancer in this population.
Abstract:
A 45-year-old woman, known to have a congenital exstrophy ofthe bladder, for which she underwent a ureterosigmoidostomy in her infancy, presented with fever. This was due to pyelonephritis, from which she recovered with antibiotic therapy. During colonoscopy a carcinoma of the sigmoid was found at the level of the anastomosis of the ureters. Patients with a ureterosigmoidostomy have a one hundred-fold increased risk of colon carcinoma compared to the general population. The development of malignant tumours as a long-term complication of this procedure is linked with the frequent contact between intestinal tissue and urine. Periodical colonoscopy of these patients is advised.
