Ileal Loop Stenosis: A Late Complication of Urinary Diversion

Abstract

Stenosis of the ileal conduit was a late complication in 12 patients (10 adults) who underwent urinary diversion by this means. The duration of the ileal loop at diagnosis ranged from 4-14 yr, averaging 9 yr. Loop stenosis was generally without symptoms and was suggested only by routine excretory urography, while loopography confirmed the diagnosis. The etiology of the condition is not clear. A variety of possible factors is considered, including microvascular ischemia, urine-borne toxic material, infectious and allergic stimuli and an immunologic defect. The pathogenesis of the condition appears based upon a chronic inflammatory reaction, with progressive fibrosis in the mucosa and submucosa of the ileal segment.