Obstructive Uropathy: a retained urethral catheter within an ileal conduit

Abstract

Following an ileal conduit (IC) urinary diversion for intractable urinary incontinence, a woman in her 50s presented with deteriorating renal function during a routine follow-up. This decline prompted further investigation with an ultrasound scan (USS), which demonstrated bilateral hydroureteronephrosis and an atrophic left kidney. Although the mercaptoacetyltriglycine (MAG-3) renogram was inconclusive in revealing urinary obstruction, a subsequent computed tomography (CT) scan uncovered a calcified tube-like structure within the IC and hydroureteronephrosis extending to this level.To address the obstructive uropathy, a right nephrostomy was inserted, which resulted in improved renal function. A looposcopy was then performed, revealing an encrusted urethral catheter within the IC. Using techniques adapted from percutaneous nephrolithotomy, we were able to endoscopically fragment the encrustation on the catheter and remove it intact through the IC.

Keywords: Catheterisation / catheter care; Interventional radiology; Urinary tract infections; Urological surgery.