Delivering antibiotics directly into a urostomy stoma has successfully prevented recurrent urinary tract infections (UTIs) in a patient with an ileal conduit, according to early research presented by Professor Bob Yang at the 46th Congress of the Société Internationale d’Urologie (SIU 2026).
The clinical team at the Royal Berkshire Hospital reported on a 56-year-old woman who had previously undergone a cystectomy resulting in an ileal conduit, a passage constructed from a short section of bowel that carries urine to an abdominal opening (urostomy) where it drains into an external bag.
Prior to this intervention, the patient suffered from chronic low-level kidney pain and experienced 13 UTI episodes requiring antibiotics, alongside three hospital admissions, all within a single year.
To combat these repeated kidney infections, Professor Yang’s team developed a novel technique to administer gentamicin directly into the conduit via a catheter. This marks the first documented use of this specific approach for recurrent UTI prevention in a patient with an ileal conduit. The treatment programme commenced with daily administration for four weeks, tapered to alternate days for nine weeks, and then twice weekly for 12 weeks. The patient has continued a gradual weaning process and is currently maintaining a once every 5 days dose. Initially administered in an outpatient clinic setting, the patient was subsequently trained to perform the procedure independently at home.
The clinical outcomes over the past year have been significant. The patient’s longstanding kidney pain has entirely resolved, and she has experienced no further UTIs or required any additional oral or intravenous antibiotics.
Blood tests during the initial daily treatment phase demonstrated no increase in blood gentamicin levels and no changes in kidney or liver function. This confirms that the antibiotic acted locally on the target area without systemic absorption, thereby preventing unwanted side effects. Brief discomfort around the kidney area during administration indicated the treatment was successfully flushing into both kidneys, an effect that resolved quickly.
Professor Yang, Consultant Urological Surgeon at The Forbury Clinic and Royal Berkshire Hospital, commented:
“For people living with a urostomy, recurring urinary infections can mean repeated antibiotic treatment, hospital admissions, and considerable disruption to daily life. More importantly, the open access means any infection can travel straight up into the kidneys rapidly, causing sepsis.
“In this case, delivering gentamicin directly through the urostomy was followed by a period of over a year without further infections or the need for additional oral or intravenous antibiotics. The antibiotic also wasn’t being absorbed into the rest of the body, protecting the patient from unwanted side effects. The patient was also able to learn to administer the treatment herself at home, which meant minimal disruption to the patients day to day life.
“That is encouraging, but this is one patient’s experience. We need longer follow-up and further studies to establish how well the approach works, assess its long-term safety, and understand which patients might benefit.”
