Recrudescent pouch calculi in cutaneous continent diversion

Abstract

Reservoir pouch calculi are the most common complication following continent urinary diversion. The presence of calculi in the neobladder can be silent or provoke flank pain, hematuria, and urinary tract infections. Minimal invasive interventions like endoscopic or percutaneous retrieval in smaller calculi to open surgical approaches in large calculi is some of the treatment modalities. Here we present a 34-year-old patient who is a known case of exstrophy-epispadias complex, underwent bladder closure at one year of age and continent cutaneous urinary diversion (Modified Indiana pouch) 26 years ago. Plain and contrast computerized tomography showed multiple large calculi six in number, inside the pouch. In this case, the calculi were successfully managed through an open surgical approach.