Urology: ureterosigmoidostomy complications: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Urology: ureterosigmoidostomy complications

Sample item

A 30-year-old man had ureterosigmoidostomy for bladder exstrophy in infancy. Besides hyperchloraemic acidosis, for which late complication does he need surveillance colonoscopy?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Adenocarcinoma at the ureterocolic anastomosis

In ureterosigmoidostomy, urine mixes with faeces and the colon reabsorbs chloride, causing hyperchloraemic metabolic acidosis. Contact of urine with colonic mucosa at the anastomosis also induces adenomas and adenocarcinoma many years later, so long-term colonoscopic surveillance is needed.

Option by option

  • A. Adenocarcinoma at the ureterocolic anastomosis (correct)

    Correct. Urine and faecal carcinogens at the anastomosis predispose to adenocarcinoma.

  • B. Lymphoma of the colon

    Colonic lymphoma is not a recognised complication of this operation.

  • C. Squamous carcinoma of the sigmoid colon

    Tumours at the ureterocolic junction are adenocarcinomas, not squamous carcinomas.

  • D. Carcinoid tumour of the ileum

    Carcinoid tumours are not associated with urinary diversion.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is A, Adenocarcinoma at the ureterocolic anastomosis. In ureterosigmoidostomy, urine mixes with faeces and the colon reabsorbs chloride, causing hyperchloraemic metabolic acidosis.

Why is "Lymphoma of the colon" not the answer?

Colonic lymphoma is not a recognised complication of this operation.

Why is "Squamous carcinoma of the sigmoid colon" not the answer?

Tumours at the ureterocolic junction are adenocarcinomas, not squamous carcinomas.

Why is "Carcinoid tumour of the ileum" not the answer?

Carcinoid tumours are not associated with urinary diversion.

What concept does this question test?

It tests Urology: ureterosigmoidostomy complications in General Surgery. Contact of urine with colonic mucosa at the anastomosis also induces adenomas and adenocarcinoma many years later, so long-term colonoscopic surveillance is needed.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Urology: ureterosigmoidostomy complications?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.