Giant pouch stones as a surgical challenge decades after a continent ileal pouch

Continent cutaneous urinary diversion pouches are prone to complications like stoma blockage by mucus, metabolic derangements, infection, renal derangements and urolithiasis. Pouch urolithiasis is not uncommon, but presentation of a huge stone burden is rare. We report a case of giant pouch stones in a continent pouch which was a surgical challenge. We also highlight the need for adequate hydration, pouch irrigation and drainage by clean intermittent catheterization and regular follow-up, to prevent such a condition from arising.