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Successful management of a high-output urinary fistula following radical cystectomy and ileal conduit: a conservative approach
  1. Harkirat Singh Talwar,
  2. Vikas Kumar Panwar,
  3. Ankur Mittal and
  4. Rudra Prasad Ghorai
  1. Department of Urology, All India Institute of Medical Sciences—Rishikesh, Rishikesh, India
  1. Correspondence to Dr Ankur Mittal; departmenturologyaiimsrksh{at}


Urinary leak following ileal conduit after a radical cystectomy is a rare yet serious complication which presents early in the postoperative period. We herein present a case of a 38-year-old man diagnosed with recurrent high-grade non-muscle invasive bladder carcinoma. He underwent robot-assisted radical cystectomy and bilateral pelvic lymph node dissection. Postoperatively, the patient developed a high output urinary fistula (800–1000 mL/day) which was confirmed by fluid creatinine levels and a contrast study. He was managed successfully with a conservative approach. The leak subsided in 6 weeks and on follow-up patient is doing well. Most of the literature favours a surgical approach in such cases, however with optimal nutritional support (enteral/parenteral), adequate diversion of urine, percutaneous drainage of undrained collections, adequate intravenous antibiotics and good nursing care, resurgery with its associated morbidity can be avoided resulting in successful outcomes.

  • cancer intervention
  • urological cancer
  • urological surgery
  • urology

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  • Contributors HST: manuscript preparation. VKP: manuscript editing. AM: primary treating consultant, final approval. RPG: data collection.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.