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Urinary Diversion with Left Sided Ileal Conduit for Neurogenic Bladder in a Patient with Sacral Agenesis and Situs
Sushna Khanal1, Nirav Ojha2, Aashis Poudel3
1Department of General Surgery and Urology, Kirtipur Hospital, Kathmandu.
Abstract:
Sacral agenesis is a rare cause of neurogenic bladder which leads to urinary incontinence, recurrent urinary tract infections, and progressive renal dysfunction. The coexistence with situs inversus adds anatomical complexity, posing challenges in clinical and surgical management. We reported a case of a 23-year-old male with sacral agenesis and situs inversus presenting with incontinence and recurrent urinary tract infections. The patient was non-compliant to clean intermittent selfcatheterization. He underwent successful urinary diversion with a left-sided ileal conduit. Postoperative recovery was uneventful, with improved renal parameters and quality of life. Urinary diversion using a left-sided ileal conduit is a rare but feasible option for treatment when right-sided diversion is contraindicated. This case highlights that left-sided ileal conduit is a safe and effective option in managing neurogenic bladder in the context of sacral agenesis and situs inversus, underscoring the need for early recognition and individualized surgical planning in congenital anomalies.
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