A 28-year-old man with chronic diarrhea was referred for
colonoscopy. He had been diagnosed as having urinary bladder exstrophy at
birth, which was surgically repaired with bilateral ureterosigmoidostomy to
divert the flow of urine. He had no fecal or urinary incontinence. Both
abdominal and testicular ultrasound scans were normal.
Colonoscopy revealed two sessile polyps in the sigmoid area ([Fig. 1]). The polyps were
3 – 4 mm in diameter and at a distance of
5 cm from each other. These two “polyplike” structures
corresponded to the sigmoid orifices of the two ureters.
Fig. 1 a, b Polypoid
lesions (arrows) at the sigmoid orifices of the diverted ureters in a patient
with a history of bladder exstrophy.
Ureterosigmoidostomy exposes the colon to a carcinogenic mixture of
urine and feces, which necessitates annual follow-up examinations to monitor
malignant transformation in the sigmoid colon and the rectal area
[1]. The polypoid or polypoidlike lesions should not be
removed inadvertently by endoscopic polypectomy in patients who have had
ureterosigmoidostomy to avoid damaging the anastomosis, which could result in
urinary leakage [2].
Endoscopy_UCTN_Code_CCL_1AD_2AC
