Bilateral nephroureterectomy with cystoprostatectomy ad bloc and lymphadenectomy in a patient with end-stage renal failure and cancer of the urinary bladder T2BN0M0


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Abstract

The article introduces a clinical example of a patient who was first diagnosed with bladder cancer, which contributed to the development of end-stage renal failure. Initially, given the significant upper urinary tract retention and post renal acute renal failure, the patient underwent bilateral percutaneous nephrostomy. Taking into account periodic gross hematuria, cystoscopy and transurethral electrocoagulation and biopsy of bladder tumor were performed and bladder cancer was identified. Despite adequate functioning of nephrostome drainage and daily urine output up to 3000 ml, kidney failure was not resolved. After creation of an arteriovenous fistula, a hemodialysis program was launched. The patient continued to experience persistent gross hematuria, he had a hectic fever, which was estimated as a symptom of acute pyelonephritis. The patient was scheduled for bilateral nephroureterectomy, cystoprostatectomy as the only option to remove the source of bleeding and infection. The operation was carried out without complications. The patient is currently maintained on chronic hemodialysis and followed by an oncologist at the place of residence; there are no data of bladder cancer recurrence.

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About the authors

V. I Vtorenko

SBIH CCH № 52 of Moscow Healthcare Department

Department of Urology

R. N Trushkin

SBIH CCH № 52 of Moscow Healthcare Department

Ph.D., Head of Department of Urology

A. E Lubennikov

SBIH CCH № 52 of Moscow Healthcare Department

Department of Urology

O. L Podkorytova

SBIH CCH № 52 of Moscow Healthcare Department

Department of Urology

P. I. Motin

SBIH CCH № 29 n.a. N.E. Bauman of Moscow Healthcare Department

Department of Urology

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