Conduit over conduit reconstruction of retracted and fibrosed ileal conduit in severe abdominal adhesions

We report a unique case of a patient who underwent cystectomy with ileal conduit for nonmalignant bladder disease. Patient postoperatively developed stomal necrosis which was managed conservatively but after few months there was severe stomal stenosis and retraction and patient ended up with bilateral nephrostomies. On planned open abdominal exploration with intention to refashion stoma, after resection of distal stenosed segment we found that it was impossible to mobilize proximal portion of conduit due to severe small bowel adhesions. We used a unique approach of creating one more ileal conduit, bringing it as a new stoma on one side and anastomosing its other side with proximal one (ileal conduit over conduit) to augment deficient portion. This technique is not mentioned in the literature and as such we are reporting same as it can help many urologists who may encounter such problems.