THE STORY OF AN INCREDIBLE FIGHT FOR LIFE

A year ago, a 70-year-old man was urgently been brought to the N. Lopatkin Scientific Research Institute of Urology and Interventional Radiology (SRIUIR) in the most serious condition: his right lower limb was damaged at the ankle level, his ankles were fractured, his right arm was fractured, but most of all his pelvis and genitourinary system were damaged. So what happened to him?

Our patient turned out to be a neurosurgeon from Bryansk, who in his spare time is fond of mountaineering. During an expedition to the Tien Shan, he and his team fell under a snow avalanche, under which they all spent three days! Only six people managed to escape – Mikhail Konstantinovich was among them.

He received severe frostbite of his limbs. For about 20 days he was treated in Dushanbe. When the doctor became transportable, he was sent home. But fate continued to test his strength. During the flight, the helicopter broke down and the machine crashed to the ground. Three crew members died in the crash, but our patient was among the survivors.

In Moscow, he was taken directly from the airport to the Research Institute of Urology and Interventional Radiology.

The attending physician – Ph.D. A.V. Verzin, head of the microsurgery and urologic trauma group, says: “The patient was in the most serious condition, with great blood loss and unconsciousness. Our first task was to bring him out of this condition.”

The man could not move – the pelvic bones were badly damaged, but the traumatologists could not take him for surgery: in the left inguinal region there was a vesicovaginal fistula, which could give great complications. And before stabilizing the pelvis, the doctors needed to get rid of the fistula.

For a month we solved this problem – we closed the fistula,” continues Andrei Viktorovich’s story. – We installed bilateral nephrostomies (catheters for urine diversion) in the kidneys. And only then our colleagues-traumatologists at the N.N. Priorov Central Institute of Traumatology started to restore the pelvic bones.

The peculiarity of polytraumas is that not only the urogenital system and bones are damaged, but also nerves, vessels, and the sensitivity of the organ is disturbed. After going through many difficulties and surgeries, the mountaineering doctor was put on his feet, and he was able to fulfill all natural needs on his own.

The doctors breathed a sigh of relief. However, after 3 months the patient began to have problems with urination. Urethroscopy revealed that the long anatomical fusion of the pelvic bones had caused displacement of the genitourinary organs: the bladder had become attached to the pelvic bones and began to shrink in size.

The patient was taken back to the table. During this operation, which requires great manual dexterity and experience, the doctors performed another miracle: they detached the bladder from the bones and restored the normal bladder volume. For the time being, defecation is carried out with a special drainage tube – a cystostomy.

Now our hero is almost completely rehabilitated: he walks without a stick, operates on his own, skis, walks regularly and is preparing for another stage of treatment. He will have to undergo a urethral repair surgery, which Dr. Verzin has planned for March 2024 so that he can do without a cystostomy. And then the doctors will be able to say to their patient, “You are completely healthy!”