Ureterosigmoidostomy is a method for total diversion of the urinary stream away from the bladder and lower urinary tract into the sigmoid colon, the anus providing the continence mechanism for urine as well as for faeces. However, this type of urinary diversion has multiple serious mid- and long-term complications, including anastomotic colon cancer, ascendens urinary infection, hyperchloremic metabolic acidosis, electrolyte imbalance, incontinence and urinary stone. This case report describes the diagnostic and therapeutic approach to a case in which ureterosigmoidostomy had been carried out, with nephrectomy being performed 30 years following this intervention, after pyelonephritis developed by way of ascendens infection, and which was then operated on three years later, upon the appearance of sigmoid colon carcinoma.