Recurrent Ileal Conduit Obstruction Secondary to Parastomal Hernia Resulting in Bilateral Hydronephrosis and Pyelonephritis

Parastomal hernia is a recognized long-term complication following ileal conduit urinary diversion, though associated urinary obstruction is not very common. We report the case of a 63-year-old woman with an extensive history of abdominal and urological surgery who presented with bowel obstruction symptoms, reduced conduit output, and acute kidney injury. Cross-sectional imaging demonstrated bilateral hydronephrosis and hydroureter along with bilateral pyelonephritis secondary to extrinsic compression of the ileal conduit by a parastomal hernia containing the cecum. Intraconduit catheterization made a significant clinical and biochemical recovery through decompression. In cases of prohibitive operative risk, long-term conduit catheterization became the practice based on multidisciplinary agreement. The case has brought to focus the diagnostic and management issues of rare urinary complications due to parastomal hernia in patients with hostile abdomens.