Abstract
Ureterosigmoidostomy is one of the oldest technique for continent urinary diversion. Though less common nowadays, it is still a useful form of urinary diversion; simple to perform, offers good continence with minimal interference with life style. It still has a major role in conditions like ectopia vesicae and post-radical cystectomy for bladder carcinoma. We present a case of 33 years lady who underwent ureterosigmoidostomy at the age of 10 years for ectopia vesicae and later developed left pyonephrosis due to distal ureteric calculus. Left sided PCN was done and successful antegrade endoscopic removal of calculus relieved her symptoms.
Highlights
Ectopia vesicae is caused by incomplete development of anterior bladder wall and infra-umbilical part of anterior abdominal wall owing to delayed rupture of the cloacal membrane, leaving the posterior bladder wall lying exposed on the abdomen
Bladder reconstruction is the treatment of choice but cystectomy and urinary diversion is performed for late presentation
The use of ureterosigmoidostomy as a urinary diversion has greatly reduced due to high incidence of complications and availability of other safer procedures
Summary
Ectopia vesicae is caused by incomplete development of anterior bladder wall and infra-umbilical part of anterior abdominal wall owing to delayed rupture of the cloacal membrane, leaving the posterior bladder wall lying exposed on the abdomen It is a rare condition with approximate incidence of 1 in 50,000 live births.[1] Recurrent urinary tract infection and gradual hydroureteronephrosis due to ureterovesical obstruction leads to progressive renal function deterioration if not treated in time. A 33 years lady presented with colicky left loin pain which became severe and associated with fever for one week She had had similar episodes in past. XRay KUB showed left distal ureteric calculus and widely separated pubic bones (Fig. 1). The diagnosis of left lower ureteric calculus with pyelonephritis in a patient with ureterosigmoidostomy for ectopia vesicae www.jiom.com.np. The DJ-stent was self expelled on 4th post-operative day and patient was discharged with uneventful recovery
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