TY - JOUR

T1 - Симультанные операции на нижних мочевыводящих путях

AU - Панферов, А.С.

AU - Гаджиев, Нариман Казиханович

AU - Ястребов, В.С.

PY - 2026/5/14

Y1 - 2026/5/14

N2 - The article presents a clinical case of successful simultaneous laparoscopic intervention in a 70-year-old patient with combined diseases of the lower urinary tract: large benign prostatic hyperplasia (113 cm3) and iatrogenic stricture of the lower third of the right ureter, which developed after contact ureterolithotripsy. The patient’s complications included an obstructive ureteral stone, stricture formation with hydronephrosis, secondary pyelonephritis, prostate abscess after a transrectal biopsy, and acute urinary retention, which required a comprehensive surgical approach. The intervention involved laparoscopic transvesical adenomectomy and Boari ureteralplasty. The surgery lasted 120 minutes, and the blood loss was 100 ml. The postoperative period was uneventful. Follow-up examinations after 3 and 6 months showed a significant improvement in functionality. The article presents a clinical case of successful simultaneous laparoscopic intervention in a 70-year-old patient with combined diseases of the lower urinary tract: large benign prostatic hyperplasia (113 cm3) and iatrogenic stricture of the lower third of the right ureter, which developed after contact ureterolithotripsy. The patient’s complications included an obstructive ureteral stone, stricture formation with hydronephrosis, secondary pyelonephritis, prostate abscess after a transrectal biopsy, and acute urinary retention, which required a comprehensive surgical approach. The intervention involved laparoscopic transvesical adenomectomy and Boari ureteralplasty. The surgery lasted 120 minutes, and the blood loss was 100 ml. The postoperative period was uneventful. Follow-up examinations at 3 and 6 months demonstrated a significant improvement in functional parameters: the maximum urine f low rate (Qmax) increased from 5.3 to 20.2–23.4 ml/s, and the residual urine volume decreased from 130 to 0 ml. There was an improvement in kidney function (decreased serum creatinine levels and increased GFR) and resolution of hydronephrosis. No signs of detrusor overactivity, vesicoureteral ref lux, or ref lux pyelonephritis were detected, indicating that the anastomosis was successful and that the bladder function was preserved. The authors emphasize the main advantages of the simultaneous approach: the radical treatment of multiple diseases with a single anesthesia and hospitalization, the reduction of the overall rehabilitation period, and the decrease in the overall surgical risk. This observation illustrates the relevance of simultaneous surgeries in modern urology, especially for elderly polymorbid patients, and demonstrates their high efficiency and safety with careful preoperative planning. The introduction of such techniques into routine practice can optimize the treatment of patients with complex combined diseases of the lower urinary tract.

AB - The article presents a clinical case of successful simultaneous laparoscopic intervention in a 70-year-old patient with combined diseases of the lower urinary tract: large benign prostatic hyperplasia (113 cm3) and iatrogenic stricture of the lower third of the right ureter, which developed after contact ureterolithotripsy. The patient’s complications included an obstructive ureteral stone, stricture formation with hydronephrosis, secondary pyelonephritis, prostate abscess after a transrectal biopsy, and acute urinary retention, which required a comprehensive surgical approach. The intervention involved laparoscopic transvesical adenomectomy and Boari ureteralplasty. The surgery lasted 120 minutes, and the blood loss was 100 ml. The postoperative period was uneventful. Follow-up examinations after 3 and 6 months showed a significant improvement in functionality. The article presents a clinical case of successful simultaneous laparoscopic intervention in a 70-year-old patient with combined diseases of the lower urinary tract: large benign prostatic hyperplasia (113 cm3) and iatrogenic stricture of the lower third of the right ureter, which developed after contact ureterolithotripsy. The patient’s complications included an obstructive ureteral stone, stricture formation with hydronephrosis, secondary pyelonephritis, prostate abscess after a transrectal biopsy, and acute urinary retention, which required a comprehensive surgical approach. The intervention involved laparoscopic transvesical adenomectomy and Boari ureteralplasty. The surgery lasted 120 minutes, and the blood loss was 100 ml. The postoperative period was uneventful. Follow-up examinations at 3 and 6 months demonstrated a significant improvement in functional parameters: the maximum urine f low rate (Qmax) increased from 5.3 to 20.2–23.4 ml/s, and the residual urine volume decreased from 130 to 0 ml. There was an improvement in kidney function (decreased serum creatinine levels and increased GFR) and resolution of hydronephrosis. No signs of detrusor overactivity, vesicoureteral ref lux, or ref lux pyelonephritis were detected, indicating that the anastomosis was successful and that the bladder function was preserved. The authors emphasize the main advantages of the simultaneous approach: the radical treatment of multiple diseases with a single anesthesia and hospitalization, the reduction of the overall rehabilitation period, and the decrease in the overall surgical risk. This observation illustrates the relevance of simultaneous surgeries in modern urology, especially for elderly polymorbid patients, and demonstrates their high efficiency and safety with careful preoperative planning. The introduction of such techniques into routine practice can optimize the treatment of patients with complex combined diseases of the lower urinary tract.

KW - Simultaneous surgical treatment

KW - cystotomy

KW - lower urinary tract pathology

KW - prostate hyperplasia

KW - ureteral stricture

UR - https://www.mendeley.com/catalogue/570265f1-56f7-3684-92da-6f23e138011b/

U2 - 10.18565/urology.2026.2.140-145

DO - 10.18565/urology.2026.2.140-145

M3 - статья

SP - 140

EP - 145

JO - УРОЛОГИЯ

JF - УРОЛОГИЯ

SN - 1728-2985

IS - 2

ER -