Hemiresective reconstruction of a redundant ileal conduit with severe bilateral ileal conduit-ureteral re fl ux.
A 58-year-old man was referred to our hospital with high fever and anuria. Since undergoing a total pelvic exenteration due to bladder-invasive sigmoid colon cancer, urinary tract infections had frequently occurred. We treated with the construction of a bilateral percutaneous nephrostomy (PCN), and chemotherapy. Although we replaced the PCN with a single J ureteral catheter after an improvement of infection, urinary infection recurred because of an obstruction of the catheter. Urological examinations showed that an ileal conduit-ureteral reflux caused by kinking of the ileal loop was the reason why frequent pyelonephritis occurred. We decided to resect the proximal segment to improve conduit-ureteral reflux for the resistant pyelonephritis. After the surgery, the excretory urogram showed improvement and the urinary retention at the ileal conduit disappeared. Three years after the operation, renal function has been stable without episodes of pyelonephritis. Here we report a case of open repair surgery of an ileal conduit in a patient with severe urinary infection.
Fujimura
Tetsuya
T
Department of Urology, International Medical Center of Japan, Tokyo, Japan. jolly-poo@mub.biglobe.ne.jp
Minowada
Shigeru
S
Kishi
Hiroichi
H
Hamasaki
Kimihisa
K
Saito
Kiyoshi
K
Kitamura
Tadaichi
T
D006801:Humans; D007082:Ileum / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012720:Severity of Illness Index; D014547:Urinary Diversion / Q000009:adverse effects / Q000379:methods; D014567:Urography; D014718:Vesico-Ureteral Reflux / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*