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Published on: April 17, 2020
Successful Dilation of Ileal Conduit Stenosis 47 Years After Construction: The Longest Reported Interval in the
Ayaka Igarashi1, Seiji Arai1, Sho Watanuki1
1Department of Urology Gunma University Hospital Maebashi Gunma Japan.
Introduction:
Ileal conduit diversion is commonly performed after cystectomy and is considered the gold standard. However, late complications can occur.
Case Presentation:
A 74-year-old woman had undergone cystectomy with ileal conduit diversion for neurogenic bladder dysfunction 47 years earlier. She presented with recurrent urinary tract infections and bilateral hydroureteronephrosis. Imaging revealed conduit stenosis and impaired bilateral renal function. Endoscopy of ileal conduit revealed a pinhole-like stenosis on the proximal side. A 10-Fr catheter was advanced across the stenotic segment, resulting in pyelonephritis resolution and renal function improvement. After 1 month, the catheter was upsized to 16-Fr. Five months later, the catheter was spontaneously expelled, and good urine flow was maintained, with no recurrence over 2 years of follow-up.
Conclusion:
Ileal conduit stenosis can occur even decades after urinary diversion and can be managed effectively by stepwise dilation. The present case highlights the need for lifelong surveillance in ileal conduit patients.
