Ureterosigmoidostomy and carcinoma of the colon

The etiology for the development of colon carcinoma associated with ureterosigmoidostomy seems to be related to the urine. The incidence of colon carcinoma associated with ureterosignoidostomy is 500 times greater than in the normal population, indicating a 5 per cent lifetime risk. The development time of these lesions varies from 6 to 50 years postoperatively but development time is significantly less in patients more than 40 years old. The possibility exists that colon carcinoma may develop in primary sigmoid urinary diversion conduits or sigmoid internal conduits to either bladder or bowel. No reported bowel carcinoma has developed in an ileal urinary diversion. Follow-up evaluation should include stools for blood every 3 months after 2 years, excretory urogram yearly after 5 years, sigmoid or colonoscopy every 5 years and barium enema every 5 years. If the patient has hematochezia or the excretory urogram demonstrates ureteral obstruction sigmoid and colonoscopy should be done.