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Abstract: SA-PO203

Stone Formation in an Ileal Conduit due to a Refluxed Surgical Staple

Session Information

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical


  • Ray, Justina, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Gayle, Latoya N., Weill Cornell Medicine, New York, New York, United States
  • Shaikh, Aisha, Memorial Sloan Kettering Cancer Center, New York, New York, United States

Ileal conduits for urinary diversion are created following cystectomy. Patients with ileal conduits are at high risk for urinary tract calculi. Several factors predispose to stone formation following ileal conduit creation, including metabolic abnormalities, infections due to urea-splitting organisms, and the presence of foreign material in the ileal conduit. We describe a case of ileal conduit stone formation around a refluxed surgical staple.

Case Description

A 73-year-old female with a solitary left kidney and a history of bladder cancer underwent radical cystectomy and ileal conduit creation 10-years ago. She did not have a previous history of nephrolithiasis. She presented to the hospital after passing a stone in her urostomy bag. The stone was white in color, 2 cm in diameter, with a surgical staple encased within it (Image). The patient did not complain of abdominal or flank pain, and no hematuria or pyuria was present. CT Urogram showed no filling defect, foreign body, calculus, or dilatation of the renal calyces and pelvis. Metabolic acidosis, hypercalcemia, hyperuricemia, or hyperparathyroidism were not present. The stone was composed of 90% magnesium ammonium phosphate (struvite) and 10% calcium phosphate (apatite). No intervention was performed as no residual stones, or foreign bodies were present in the kidney or the ileal conduit.


In ileal conduits, a loose surgical staple can serve as a nidus for stone formation. In most cases, the stone is passed spontaneously without any complications. However, in some cases, the loose surgical staple can reflux from the ileal conduit into the kidney leading to nephrolithiasis. Furthermore, the surgical staple can be completely embedded within the stone and not be visible to the naked eye. In such cases, radiographic imaging of the stone can reveal the encased staple. Nephrologists must be aware of this rare complication in patients with ileal conduits where a loose surgical staple can serve as a nidus for stone formation.

Image. A stone encasing a loose surgical staple.