R.V. Savchuk, D.A. Zhukovskiy, P.S. Filippov

The evaluation of microbiota of the orthotopic and heterotopic urinary reservoirs and strategy of treatment

The radical cystectomy (RCE) in different versions is the main treatment for muscle-invasive bladder cancer (MIBC). The aim of the article is the evaluation of the bacterial spectrum of orthotopic and heterotopic urinary reservoirs in the early and late postoperative period after RCE. The 54 patients, 46 men (85.2%) and 8 women (14.8%) were taken to the study. The urine examination was performed in 19 (35.2%) patients with orthotopic bladder reconstruction by Studer, and in 35 (64.8%) patients with Bricker derivation of urine. The functional adaptation and morphological transformation of the intestinal epithelium to a new aggressive environment (urine) may occur during the first year after the orthotopic or heterotopic plasty. The mucous is the most susceptible to colonization and activity of pathogenic and opportunistic microorganisms during this period. Neocyst is more susceptible to the persistence and development of infectious and inflammatory process that requires careful control of urodynamics, the volume of residual urine and courses of antibiotic therapy according to the results of bacteriological examination of urine.