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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">urovest</journal-id><journal-title-group><journal-title xml:lang="ru">Вестник урологии</journal-title><trans-title-group xml:lang="en"><trans-title>Urology Herald</trans-title></trans-title-group></journal-title-group><issn pub-type="epub">2308-6424</issn><publisher><publisher-name>Rostov State Medical University</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21886/2308-6424-2026-14-2-124-130</article-id><article-id custom-type="elpub" pub-id-type="custom">urovest-1233</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>КЛИНИЧЕСКИЕ НАБЛЮДЕНИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>CLINICAL CASES</subject></subj-group></article-categories><title-group><article-title>Необладер-влагалищные свищи после ортотопической илеоцистопластики</article-title><trans-title-group xml:lang="en"><trans-title>Neobladder-vaginal fistulas following orthotopic ileocystoplasty</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2359-6973</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гулиев</surname><given-names>Б. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Guliev</surname><given-names>B. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Бахман Гидаятович Гулиев — д-р мед. наук, профессор </p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Bakhman G. Guliev — Dr.Sc.(Med), Full Prof.</p><p>St. Petersburg</p></bio><email xlink:type="simple">gulievbg@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Центр урологии с робот-ассистированной хирургией — Городская Мариинская больница; Северо-Западный государственный̆ медицинский̆ университет им. И. И. Мечникова</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Urology Centre with Robot-assisted Surgery — St. Petersburg Mariinsky Hospital; Mechnikov North-Western State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2026</year></pub-date><pub-date pub-type="epub"><day>09</day><month>07</month><year>2026</year></pub-date><volume>14</volume><issue>2</issue><fpage>124</fpage><lpage>130</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Гулиев Б.Г., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Гулиев Б.Г.</copyright-holder><copyright-holder xml:lang="en">Guliev B.G.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.urovest.ru/jour/article/view/1233">https://www.urovest.ru/jour/article/view/1233</self-uri><abstract><p>В статье представлены два клинических наблюдения резервуарно-влагалищного свища (РВС), редкого осложнения ортотопической цистопластики. У пациентки 42 лет после открытой радикальной цистэктомии с ортотопической илеоцистопластикой свищ успешно устранён методом фистулорафии с первой попытки. У пациентки 63 лет после робот-ассистированной цистопластики развился рецидив РВС через 2 месяца после первичного ушивания. При повторной операции дефект резервуара герметизировали биоклеем, но возник мочевой перитонит. Его устранили с помощью лапароскопии, санации и дренирования брюшной полости, в результате дефект стенки резервуара самостоятельно закрылся. В отдалённом периоде у обеих пациенток восстановлено самостоятельное мочеиспускание без недержания мочи. В обсуждении результатов описаны факторы риска развития РВС, такие как нарушение васкуляризации и интраоперационное повреждение передней стенки влагалища, совпадение линий швов, постлучевые изменения, а также подходы к хирургической коррекции: трансвагинальный и трансабдоминальный доступы. В заключении подчёркивается, что РВС устранимы, но важно учитывать риск попадания мочи в брюшную полость при негерметичности резервуара.</p></abstract><trans-abstract xml:lang="en"><p>Two clinical cases of neobladder–vaginal fistula (NVF), a rare complication of orthotopic cystoplasty, are presented. In a 42‑year‑old woman who had previously undergone open radical cystectomy with orthotopic ileal neobladder, the fistula was successfully treated by fistulorrhaphy at the first attempt. In a 63‑year‑old woman after robot‑assisted cystoplasty, NVF recurred two months after the initial repair; during re‑operation, the reservoir defect was sealed with biological glue, but the patient subsequently developed urinary peritonitis. This complication was managed laparoscopically by abdominal sanitation and drainage, resulting in spontaneous closure of the reservoir wall defect. On long‑term follow‑up, both patients achieved restoration of spontaneous voiding without urinary incontinence. The discussion addresses risk factors for NVF, including impaired vascularisation and intraoperative injury to the anterior vaginal wall, overlapping suture lines, post‑radiation changes, and other local tissue‑compromising conditions. Surgical options for NVF correction, primarily transvaginal and transabdominal approaches, are described with an emphasis on careful tissue handling and multilayer closure to ensure watertight sealing of the neobladder. The report underscores that NVFs are amenable to repair but highlights the importance of recognising the risk of intraperitoneal urine leakage in the setting of reservoir dehiscence and planning prompt intervention accordingly.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>радикальная цистэктомия</kwd><kwd>ортотопическая илецистопластика</kwd><kwd>цистопластика у женщин</kwd><kwd>резервуарно-влагалищный свищ</kwd><kwd>фистулорафия</kwd></kwd-group><kwd-group xml:lang="en"><kwd>radical cystectomy</kwd><kwd>orthotopic ileocystoplasty</kwd><kwd>female cystoplasty</kwd><kwd>reservoir-vaginal fistula</kwd><kwd>fistula repair</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Исследование не имело спонсорской поддержки.</funding-statement><funding-statement xml:lang="en">The study was not sponsored.</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Комяков Б.К., Фадеев В.А., Новиков А.И., Горелов А.И., Зубань О.Н., Сергеев А.В., Короходкина М.В., Бурлака О.О. 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