HOW SURGEONS AND UROLOGISTS SAVED A PATIENT WITH END-STAGE RENAL FAILURE AND COMPLETE URETHRAL OBSTRUCTION

A 60-year-old patient from North Ossetia was admitted to the National Medical Research Radiological Centre in critical condition. The man was undergoing hemodialysis because his kidneys had completely failed due to end-stage renal disease—a life-threatening condition in which all kidney functions are lost. In addition, he had another serious urological issue: complete urethral obstruction (obliteration), which made natural urination impossible. He relied on a cystostomy—a tube inserted through the abdomen to drain urine.

It all began with urolithiasis: kidney stones damaged the urethra as they passed through, causing it to narrow. Repeated attempts to widen the urethra through bougienage only worsened the situation, eventually leading to complete blockage.

To allow at least some form of urinary drainage, doctors at his local hospital installed a cystostomy. However, this did not solve the main issue—his chronic kidney disease kept progressing, and his condition became critical. The patient was referred to the N. Lopatkin Scientific Research Institute of Urology and Interventional Radiology – branch of the Federal State Budgetary Institution of the “National Medical Research Radiological Centre” of the Ministry of Health of the Russian Federation. He immediately sought help from the specialists there.

The medical team promptly developed a comprehensive treatment strategy.

The first step was to restore urethral patency. The operation—ureteroureteroanastomosis with plication of the corpora cavernosa—was performed by Nikolay Polyakov, head of the reconstructive urology group. The surgery was carried out using a unique method developed at the Centre, which involved using the patient’s own tissue without grafting from other areas. As a result, the patient was able to urinate naturally again, recovered quickly, and no longer needed the cystostomy.

A month later, the patient returned for the next stage of treatment—a kidney transplant. The procedure was successfully performed by Andrey Mitish, head of the kidney transplantation department.

Today, the patient is fully recovered: his kidney function has normalized, and he no longer needs dialysis. He lives without catheters or drainage systems, regaining a quality of life that he might have otherwise lost due to his illness.

This outcome was made possible thanks to a comprehensive treatment approach and the use of advanced surgical techniques available to patients from all over the country.