Abstract
Adenocarcinoma is a long-term complication of ureterosigmoidostomy and ileal conduit is the most widely used diversion after sigmoid resection. To our knowledge, we present the first documented conversion of ureterosigmoidostomy to an Indiana pouch after sigmoidectomy for cancer. CASE REPORT A 50-year-old white male was found on routine examination to have hemocult-positive stools. He had undergone ureterosigmoidostomy for bladder exstrophy at age 2 years. During colonoscopy 2 polyps in the sigmoid colon at the distal ureteral anastomotic suture line (fig. 1) were removed and invasive adenocarcinoma was diagnosed. An excretory urogram (IVP) demonstrated no hydronephrosis or renal scarring preoperatively (fig. 2). Renal and hepatic function was normal. Computerized tomography of the abdomen and pelvis revealed no metastatic disease. After reviewing the various urinary diversion options the patient underwent low anterior distal ureterosigmoid resection (10 cm.) with primary anastomosis and an Indiana pouch urinary diversion. Intraoperative findings included minimal ureteral dilatation with no evidence of metastatic disease. Pathological study revealed no residual malignant disease or ureteral dysplasia. The patient was discharged home on postoperative day 6 after an uncomplicated hospital course. Followup clinic visits revealed good pouch continence
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
