Conversion From Cutaneous Ureterostomy to Ileal Conduit in Frail Patients: A Descriptive Case Series

Cutaneous ureterostomy is frequently selected for frail patients undergoing radical cystectomy due to its reduced operative complexity. However, long-term complications such as urinary tract infections (UTIs), stomal stenosis, and catheter dependence are common. Delayed conversion to ileal conduit has been proposed as a reconstructive strategy after clinical stabilization.

Five frail patients underwent radical cystectomy with cutaneous ureterostomy followed by delayed conversion to ileal conduit. Conversion occurred 10-36 months later due to recurrent complications or improvement in clinical status. Postoperative complications occurred in four patients (80%), including UTIs requiring antibiotics (Clavien-Dindo II), urinary fistula (Clavien-Dindo I), and ureteroileal stricture requiring surgical revision (Clavien-Dindo IIIb).

Delayed conversion is feasible but is associated with significant morbidity and should remain individualized.