Surgical treatment of patients with urolithiasis after radical cystectomy with intestinal cystoplasty

Komyakov B.K., Guliev B.G., Sergeev A.V., Stecyuk E.A., Kas'yanenko S.S.

Aim of the study: to estimate the efficacy of open and minimally invasive interven-tions in patients with urolithiasis after radical cystectomy with orthotopic and het-erotopic cystoplasty. 

Materials and methods. We analyzed the data from 358 patients operated on in our center in a period from 1995 to 2015 with radical cystectomy due to bladder can-cer. Male patients were 303 (84.6%), female – 55 (15.4%). The following methods were used for the urine derivation: orthotopic – 267 patients (74.6%), ureterosigmoidostomy – 43 (12.0%), continent heterotopic ileocystoplasty – 10 (2.8%), ureterocutaneostomy – 38 (10.6%). The follow-up consisted of lab investigations, sonography and computed tomography of the abdomen and pelvis, excretory urog-raphy and dynamic scintigraphy every 6 months. 

Results. Among 277 patients thirteen (4.7%) were diagnosed with the urinary stones: ureter / kidney stones – 7 patients (2.5%) and neobladder stones in 5 (1.8%) patients, combined location – in 1 female patient (0.4%). In all cases of neobladder stones the patients were operated on using open surgery interventions due to the large and multiple stones. Ureteral and renal stones were cleared percutaneously (transurethral access is not possible). Postoperative complications were not evi-dent. 

Conclusions: ureteral and renal stones after radical cystectomy and urinary deriva-tion are the indication for the antegrade approach, while large neobladder stones should be preferably accessed openly or transurethrally. 

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bladder cancer, radical cystectomy, cystoplasty, urolithiasis, percutaneous nephrolithotripsy, cystolithotomy