Bilateral Staghorn Calculi With Stent Encrustation in a Patient With an Ileal Conduit Requiring Staged Endourological Procedures: A Case Report.

An ileal conduit represents a surgical method of urinary diversion where the ureters are anastomosed to an isolated segment of the distal ileum, which is subsequently exteriorized as a stoma. Stones in ileal conduits are a recognized late complication of urinary diversion, arising from mucus production, urease-producing infection, and impaired drainage due to uretero-ileal stenosis. We report a 30-year-old male with Down syndrome, neurogenic bladder, and chronic kidney disease who presented with bilateral staghorn calculi, stent encrustation, and a conduit calculus following prolonged loss to follow-up. He was managed with a staged, multimodal endoscopic approach combining percutaneous and transconduit techniques, achieving complete stone clearance with significant improvement in renal function. Such cases are technically challenging and require individualized management strategies, underscoring the importance of regular surveillance and early recognition of complications to prevent silent disease progression.