Ileal conduit creation is a common urinary diversion after radical cystectomy, though complications such as obstruction can occur. We report a rare case of an 80-year-old male with recurrent obstructive pyelonephritis due to an incarcerated ileal conduit in an inguinal hernia. An 80-year-old male, 27 years post-total cystectomy, presented with recurrent fever due to obstructive pyelonephritis. For three years, he suffered from repeated urinary tract obstructions attributed to kinking of the ileal conduit, requiring multiple hospitalizations and catheter placements, despite regular follow-up at our institution and affiliated hospitals. Laparoscopic exploration, initially planned for conduit repair, unexpectedly revealed the ileal conduit incarcerated within an inguinal hernia, establishing the definitive diagnosis. Although rare, incarceration of the ileal conduit should be considered in the differential diagnosis of urinary tract obstruction in patients with an ileal conduit, particularly when the cause of obstruction is unclear.
Ishikawa et al. (Fri,) studied this question.