Obstructed ureteroileal conduits: antegrade catheter drainage

The ileal loop method of supravesical urinary diversion may be complicated by strictures of the ureteroileal anastomosis, the ileocutaneous stoma, or the ileal loop itself. These strictures may produce hydronephrosis with a resultant deterioration of renal function. Decompression via percutaneous nephrostomy is frequently indicated, either as an antecedent to corrective surgery or as a permanent method of urinary drainage. A technique is described which extends the percutaneous nephrostomy to allow placement of drainage catheters from below. This obviates flank catheters and permits antegrade drainage of urine through the preexisting ileocutaneous stoma into the usual collecting appliance. The method has been applied successfully in three patients.