Ileal conduit stomal stenosis is a difficult complication to manage. Definitive treatment usually requires refashioning or a reconstruction of the conduit. There remains a need for minimally invasive procedures that can restore function to the stoma while avoiding the risks associated with a significant surgical procedure.
This case illustrates a novel approach to the management of this complication.
An 84 year old female with muscle-invasive bladder cancer underwent cystectomy with formation of an ileal conduit urinary diversion system. Her recovery was complicated by stomal stenosis leading to recurrent urinary tract infections. The Memokath Stent 045 is a thermo-expandable nickel-titanium stent designed for treatment of urethral strictures. The stent was inserted into the stoma under direct vision without the need for general anaesthesia or intraoperative radiography. The conduit remains patent 12 months after insertion and the metal stent showed no evidence of migration, calcification, oxidation or degradation.
The use of a thermo-expandable nickel-titanium stent is able to provide the patency required to treat ileal conduit stomal stenosis. In this case, insertion of the stent was a simple procedure and no adverse events or degradation of the stent was identified at 12 months after insertion. The need for a significant surgical procedure such as a refashioning or reconstruction was avoided and general anaesthesia was not required to perform the procedure.
This case report highlights the possibility of using the thermo-expandable Memokath Stent 045 as an alternative to the long-term management of ileal conduit stomal stenosis.
International journal of surgery case reports. 2015 Dec 24 [Epub ahead of print]
Tzong-Yang Pan, Ahmad Al-Sameraaii
The Canberra Hospital, ANU Medical School, Canberra Hospital Campus, Building 4, Hospital Road, Garran, Canberra ACT 2605, Australia; Calvary Health Care ACT, Corner of Belconnen Way & Haydon Drive, Bruce, Canberra ACT 2617, Australia. Calvary Health Care ACT, Corner of Belconnen Way & Haydon Drive, Bruce, Canberra ACT 2617, Australia.