A case of peristomal ulcer treated by ureteral stenting and negative-pressure wound therapy

Abstract

Background:Peristomal skin ulcers are often difficult to treat. We report a case of ileal conduit peristomal skin ulcer that was successfully treated with ureteral stenting and negative pressure wound therapy(NPWT).
Case:A 55-year-old woman was diagnosed with muscle invasive bladder cancer. After two courses of neo-adjuvant cisplatin-based chemotherapy, she underwent radical cystectomy with ileal conduit construction. Within a month following the operation, she developed a peristomal skin ulcer that was exacerbated by administration of adjuvant chemotherapeutic drugs. However, ureteral stenting and NPWT improved the ulceration, which resolved after completion of three courses of adjuvant chemotherapy.
Discussion:We assumed that chemotherapeutic agents in the patient's urine caused the ulceration of the peristomal skin. The ureteral stenting and NPWT protected the skin lesion from the urine contamination, leading to a complete resolution of the ulcer. Effective treatments for ileal conduit peristomal skin ulcer are needed because of the growing number of patients with bladder cancer that require radical cystectomy with ileal conduit construction.
Conclusion:A combination of ureteral stenting and NPWT could be an effective treatment for severe ileal conduit peristomal skin ulcer.