Urinary Bowel Stone: Calculus Formation in a Repurposed Small Intestine - a Case Report

Background: Urinary diversion with an ileal conduit is associated with an increased risk of urinary tract calculi, driven by metabolic disturbances, recurrent infections, urinary stasis, and foreign bodies. Although stone formation is a known complication, calculi developing around migrated surgical material remain an uncommon and underreported occurrence. Case Presentation: An 81-year-old male patient with a history of radical cystectomy and ileal conduit formation for invasive urothelial carcinoma presented with flank pain and urinary tract infection four years after surgery. Morphological analysis of two spontaneously expelled urinary stones retrieved from the conduit drainage bag classified both calculi as type IVc, with a central nucleus composed of surgical staples. Fourier-transform infrared spectroscopy revealed a mixed composition of struvite (80%) and sodium hydrogenurate (20%), consistent with infection-related lithiasis. The findings supported stone formation around migrated foreign material in the context of chronic bacteriuria. Conclusion: Surgical staple migration can act as a nidus for infection-related stone formation in patients with ileal conduits, even several years after cystectomy. Stone analysis plays a crucial role in identifying foreign-body–associated calculi and possible underlying mechanisms. Clinicians should maintain a high index of suspicion for urolithiasis in patients with urinary diversions presenting with flank pain or recurrent infections.