Ureteroileal anastomotic stricture (ileal conduit)

Discussion:

An ileal loop conduit can be investigated with either retrograde urography (loopogram) or with CT urography (CTU), and both have advantages and disadvantages.

CTU allows one to investigate the soft tissues around the urinary diversion more thoroughly than a loopogram does. If there is thickening of the ureter, mass effect on the ileal conduit or ureter, or a filling defect, a CTU may be able to characterize it with more specificity than a loopogram can.

A loopogram, on the other hand, allows a dynamic component to the evaluation of the ileal conduit. A narrowing can be mildly stressed with pressure from contrast and one can watch if the narrowing is fixed and over what length. The rate of opacification (and voiding) also offers diagnostic information, as seen in this case.

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