Ureterosigmoidostomy and Carcinoma of the Colon

Abstract

The etiology for development of colon carcinoma associated with ureterosigmoidostomy seems to be related to the urine. The incidence of colon carcinoma associated with ureterosigmoidostomy is 500 times greater than in the normal population, indicating about a 5% lifetime risk. The development time of these lesions varies from 6-50 yr postoperatively, but it is significantly less in patients more than 40 yr old. The possibility exists that colon carcinoma may develop in primary sigmoid urinary diversion conduits or sigmoid internal conduits to either bladder or bowel. No reported bowel carcinoma has developed in an ileal urinary diversion. Follow-up examination should include stools for blood every 3 mo. after 2 yr, an excretory urogram yearly after 5 yr, sigmoid or colonoscopy every 5 yr and Ba enema every 5 yr. If the patient has hematochezia or the excretory urogram demonstrates ureteral obstruction, sigmoid or colonoscopy and a Ba enema should be done.