An ileal conduit diverts urine from the upper urinary tracts to a reservoir formed from which portion of the intestine?

• A. Renal failure
• B. Hypertension
• C. Diabetes mellitus
• D. Severe Crohn's disease

Answer: (D)

Urinary diversions often use a piece of intestine to create a channel or storage pouch for urine. For an ileal conduit, a segment of the ileum is used to connect the ureters to the abdominal stoma. The ileum is chosen because it can be fashioned into a conduit or, when detubularized, into a low-pressure reservoir that can hold urine. It also tends to have manageable mucus production compared with other segments like the colon. Keep in mind that using ileal tissue can alter urinary chemistry, potentially causing metabolic changes, so monitoring is important. If the ileum is diseased or involved in conditions like Crohn’s disease, surgeons may avoid using that segment and opt for another intestinal segment or approach.