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Delayed presentation of iliopsoas abscess from ureterosigmoidostomy stump fistulization 30 years following nephrectomy

Lei Chu, Marc C. Smaldone, Ronald M. Benoit

Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
Address correspondence to Dr. Lei Chu, Department of Urology, University of Pittsburgh School of Medicine, 3471 Fifth Avenue, Suite 700, Pittsburgh, PA, 15213 USA

Canadian Journal of Urology 2008, 15(5), 4273-4275.

Abstract

Although rarely used today for supravesical urinary diversion, ureterosigmoidostomy was commonly utilized in patients with bladder exstrophy. We report an unusual case of iliopsoas abscess developing 30 years after an ipsilateral nephrectomy in a patient with bladder exstrophy who had undergone ureterosigmoidostomy for urinary diversion more than 50 years prior. The etiology appeared to be persistent ureteral refl ux and fi stulization from a patent ureterosigmoidostomy stump. After percutaneous drainage of the abscess and intravenous antibiotic therapy, the patient was managed with complete excision of the ureterosigmoid anastomoses and creation of an ileal conduit urinary diversion.

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