IU Physicians Give Ukrainian Boy Second Chance

INDIANAPOLIS-- It’s been a long and painful road from the Ukraine to Indiana. But the trip has been worthwhile for eight-year-old Vadym Alistratova, who, with his mother, Valentina, came to the Indiana University Medical Center in search of a medical treatment that will help him live a more normal life.

Vadym and his mother left the Ukraine in late April of this year (1997) with the hope that an IU physician could repair the severe congenital abnormalities of his pelvis, urinary tract and genitalia. Richard Rink, MD, the Robert A. Garrett Professor of Pediatric Urologic Research and director of pediatric urology at the IU School of Medicine and Riley Hospital for Children, turned their hope into reality. He, along with Thomas Kling, MD, IU professor of orthopaedic surgery, and Kosmas Kayes, MD, IU assistant professor of orthopaedic surgery, performed the 18-hour operation on November 11 at Riley Hospital to repair the complicated defects that had plagued Vadym since birth.

Valentina suspects radiation fall-out from the Chernobyl explosion might be the cause of her son’s birth defects. She says that five other children in their town were born with the same condition. After four unsuccessful operations in the Ukraine in which physicians had attempted to reconstruct Vadym’s urinary tract and genitalia, Valentina had little hope left for a treatment that would help Vadym. She visited with missionaries at a family life center operated by Vision Ministries International, a Greencastle, Ind., based ministry. The organization arranged for she and Vadym to come to Indiana and Riley Hospital for Children.

After reviewing Vadym’s medical history and examining him at Riley Hospital, Dr. Rink was convinced that the problems could be corrected even though they were quite significant. Vadym’s pelvic bones and abdominal wall never fully developed, and the pelvic bones were widely separated. He had exstrophy of the bladder, meaning the bladder was open and exposed on the abdominal wall. The genitalia were malformed as well.

“In the United States,” explains Dr. Rink, “we fix this type of problem within the first few days of life. In Russia, physicians and surgeons simply don’t have the facilities to do a surgery of this magnitude. For Vadym, we had to undo what the Russian physicians had done and then start from scratch to reconstruct him in a way that will let him live a relatively normal life.”

The marathon surgery began at 8 a.m. with Dr. Kling and Dr. Kayes reconstructing Vadym’s pelvis. Dr. Rink then did the bladder and genitalia reconstruction. The surgery ended at about 2 a.m.

“We had a plan of action, but we didn’t know for sure what we were dealing with until we started surgery and could actually look inside,” says Dr. Rink.

After spending two weeks at Riley Hospital, Vadym was then released to the Ronald McDonald House on the Indiana University - Purdue University Indianapolis campus, where he remains under close observation. He had his partial body cast removed Dec. 15., and the orthopaedic team has begun physical therapy.

Making everything even more difficult is the language barrier between Dr. Rink and the Alistratova family, who speaks Russian. A translator was present during the pre-operative visits and on the day of surgery. Valentina has studied English while living here and now speaks and comprehends it on a basic level.

Vadym and his mother are all smiles these days. He loves to play in the game room at the Ronald McDonald House, and she is thankful that her little boy has a second chance at life. Dr. Rink is pleased with the outcome of the surgery and hopes to monitor Vadym for a few more months before the family returns to the Ukraine.

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