Clinical Nephrology » Method for surgical treatment of bladder cancer in patients with end-stage renal disease n renal replacement therapy with program hemodialysis simultaneously with the treatment and prevention of purulent pyelonephritis. Review of clinical cases

Method for surgical treatment of bladder cancer in patients with end-stage renal disease n renal replacement therapy with program hemodialysis simultaneously with the treatment and prevention of purulent pyelonephritis. Review of clinical cases

DOI: https://dx.doi.org/10.18565/nephrology.2023.2.37-43

Trushkin R.N., Martov A.G., Sokolov S.A., Isaev T.K., Shcheglov N.E., Teikhrib P.P.
1) City Clinical Hospital № 52 of the Moscow Healthcare Department, Department of Urology, Moscow, Russia; 2) D.D. Pletnev City Clinical Hospital of the Moscow Healthcare Department, Department of Urology (minimally invasive methods for diagnosing and treating urological diseases), Moscow, Russia; 3) A.I. Burnazyan Medical and Biological University of Innovations and Continuous Education nof the FMBA of Russia, Moscow, Russia; 4) Medical Scientific and Educational Center of the Lomonosov Moscow State University, Moscow, Russia

Background. Bladder cancer (BC) is one of the most common malignancies in the world and ranks 7th in the structure of oncopathology in men and 17th in women. Patients on renal replacement therapy (RRT) have been shown to have a more aggressive tumor and often a more advanced stage of the disease. In most cases, the disease is asymptomatic at an early stage and difficult to screen. As a rule, clinical manifestations and diagnosis occur at the muscle-invasive stage, where organ-preserving treatment is not possible.
Description of the clinical cases. From 2021 to 2023, 2 patients with muscle-invasive bladder cancer with end-stage renal disease (ESRD), who were on RRT with program hemodialysis, underwent surgery at the City Clinical Hospital № 52. All patients underwent laparoscopic bilateral nephroureterectomy, cystoprostatvesiculectomy, ad bloc ureterectomy.
Results. All patients underwent minimally invasive surgical treatment. There were no complications in the early and late operative periods, and there were no lethal cases. According to the results of histological examination in all patients, the kidney tissue has sclerotic changes and thinned urothelium without signs of tumor growth, mono- or bilateral apostematous pyelonephritis. The first patient had muscle-invasive urothelial bladder cancer pT2b N0. The second patient has metastases in the lymph nodes of the small pelvis. Also as an accidental finding, prostate cancer pT2N0 Gleason 6 (3+3) was detected. During the follow-up period at the outpatient settings, no data on the progression of the oncological process were received.
Conclusion. On the example of these clinical cases, it can be convinced that the radical treatment of muscle-invasive bladder cancer in patients with ESRD is possible in combination with the removal of a purulent-septic focus, and in some cases it can be a prevention of purulent-septic complications. However, in the treatment of these diseases, it is necessary to apply a multimodal approach to develop optimal methods for diagnosis and treatment.

Keywords: end-stage renal disease, cystectomy, bladder cancer, renal replacement therapy

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About the Autors

Ruslan N. Trushkin – Dr.Sci. (Med.), Head of the Urology Department, City Clinical Hospital № 52 of the Moscow Healthcare Department. Address: 3/2 Pekhotnaya st.,
Moscow, 123182; e-mail: uro52@mail.ru. ORCID: https://orcid.org/0000-0002-3108-0539.
Aleksey G. Martov – Corresponding Member of the Russian Academy of Sciences, Dr.Sci. (Med.), Professor, Head of the Department of Urology and Andrology, A.I. Burnazyan Biomedical University of Innovation and Continuing Education of the FMBA of Russia; Head of the Department of Urology (minimally invasive methods for diagnosing and treating urological diseases), D.D. Pletnev City Clinical Hospital of the Moscow Healthcare Department. Address: 32 11th Parkovaya st., Moscow, 127006, Leading Researcher at the Medical Research and Education Center of the Lomonosov Moscow State University. e-mail: martovalex@mail.ru. ORCID: https://orcid.org/0000-0001-6324-6110.
Sergey A. Sokolov – Urologist at the Urology Department, City Clinical Hospital № 52 of the Moscow Healthcare Department. Address: 3/2 Pekhotnaya st., Moscow, 123182; e-mail: sergey.sokolow@mail.ru. ORCID: https://orcid.org/0009-0004-70162360.
Teimur K. Isaev – Cand.Sci. (Med.), Urologist at the Urology Department, City Clinical Hospital № 52 of the Moscow Healthcare Department.
Address: 3/2 Pekhotnaya st., Moscow, 123182; e-mail: dr.isaev@mail.ru. ORCID: https://orcid.org/0000-0003-3462-8616.
Nikolay E. Shcheglov – Cand.Sci. (Med.), Urologist at the Urology Department, City Clinical Hospital № 52 of the Moscow Healthcare Department.
Address: 3/2 Pekhotnaya st., Moscow, 123182; e-mail nickshch@mail.ru. ORCID: https://orcid.org/0000-0002-1018-8460.
Petr P. Teikhrib – Urologist at the Urology Department, City Clinical Hospital № 52 of the Moscow Healthcare Department. Address: 3/2 Pekhotnaya st., Moscow, 123182; e-mail: teihrib_petr@mail.ru. ORCID: https://orcid.org/0009-0001-0636-0571

Method for surgical treatment of bladder cancer in patients with end-stage renal disease n renal replacement therapy with program hemodialysis simultaneously with the treatment and prevention of purulent pyelonephritis. Review of clinical cases

About the Autors

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