Surgical correction of bilateral ectopic ureter using the neoureterocystostomy technique / Correção cirúrgica de ureter ectópico bilateral utilizando a técnica de neoureterocistostomia

Ureteral ectopy is a rare disorder in the small animals' clinic. It is characterized as a congenital anomaly, resulting from the ducts differentiation failure during embryogenesis. In this scenario, the ureters present themselves outside the anatomical site, being inserted into the uterus, urethra, urinary vesicle neck, or vagina. The clinical signs are urinary incontinence and perivulvar dermatitis. Surgery is the accepted treatment to correct the anomaly. The surgical procedure is based on relocating the ectopic ureter and treating associated modifications. This report describes a case of intramural bilateral ureteral ectopy, corrected surgically through the neoureterocystostomy technique, making it possible to control the animal's urinary incontinence.(AU)

A ectopia ureteral é uma afecção de incidência rara na clínica de pequenos animais, sendo caracterizada como anomalia congênita resultante de falha na diferenciação dos ductos durante a embriogênese. Neste cenário, os ureteres se apresentam fora do seu local anatômico, sendo inseridos no útero, no colo da vesícula urinária, na uretra ou na vagina. Os sinais clínicos comumente apresentados são a incontinência urinária bem como a dermatite perivulvar. O tratamento de eleição para correção da anomalia é o procedimento cirúrgico, no qual a técnica de escolha é baseada na relocação do ureter ectópico e tratamento das alterações associadas. Neste contexto, o presente relato descreve um caso de ectopia ureteral bilateral intramural, corrigido cirurgicamente por meio da técnica neoureterocistostomia, o que possibilitou controle da incontinência urinária do paciente.(AU)

Surgical correction of bilateral ectopic ureter using the neoureterocystostomy technique / Correção cirúrgica de ureter ectópico bilateral utilizando a técnica de neoureterocistostomia

Ureteral ectopy is a rare disorder in the small animals' clinic. It is characterized as a congenital anomaly, resulting from the ducts differentiation failure during embryogenesis. In this scenario, the ureters present themselves outside the anatomical site, being inserted into the uterus, urethra, urinary vesicle neck, or vagina. The clinical signs are urinary incontinence and perivulvar dermatitis. Surgery is the accepted treatment to correct the anomaly. The surgical procedure is based on relocating the ectopic ureter and treating associated modifications. This report describes a case of intramural bilateral ureteral ectopy, corrected surgically through the neoureterocystostomy technique, making it possible to control the animal's urinary incontinence.(AU)

A ectopia ureteral é uma afecção de incidência rara na clínica de pequenos animais, sendo caracterizada como anomalia congênita resultante de falha na diferenciação dos ductos durante a embriogênese. Neste cenário, os ureteres se apresentam fora do seu local anatômico, sendo inseridos no útero, no colo da vesícula urinária, na uretra ou na vagina. Os sinais clínicos comumente apresentados são a incontinência urinária bem como a dermatite perivulvar. O tratamento de eleição para correção da anomalia é o procedimento cirúrgico, no qual a técnica de escolha é baseada na relocação do ureter ectópico e tratamento das alterações associadas. Neste contexto, o presente relato descreve um caso de ectopia ureteral bilateral intramural, corrigido cirurgicamente por meio da técnica neoureterocistostomia, o que possibilitou controle da incontinência urinária do paciente.(AU)

Ureteral stent placement using a double J-catheter in the treatment of ectopic ureter in a dog

Background: Ectopic ureter is a congenital anomaly in which the final segment of one or both ureteral orifices is locateddistal to the bladder trigone. It may be classified as intra- or extramural. Surgical treatment of ectopic ureters in dogs isrecommended and the approach varies with the classification. In the postoperative period, complications are common.When stenosis of the new ureteral ostium occurs, immediate repeated surgery is recommended. This study aimed at usingthe double J catheter placement following neoureterostomy to treat urethral obstruction secondary to the surgical treatmentof an intramural ectopic ureter in a dog.Case: An 8-month-old female French bulldog with dysuria and urinary incontinence was seen at a private veterinaryhospital in Jaboticabal, São Paulo. The patient had previously been diagnosed with an intramural ectopic ureter on theright side following imaging tests (ultrasound, computed tomography, and abdominal radiography, excretory urography)and had undergone neoureterostomy and closure of the intramural pathway approximately a year ago. Ultrasonographicexamination showed dilation of the caudal portion of the ureter and hydroureter, which was suggestive of right ureteralstenosis. Computed tomography was also performed to evaluate the kidneys, ureters, and bladder; an increase in the diameter of the right ureter in its middle portion and close to the bladder triangle was observed. A new surgical interventionwas indicated and performed. The ureteral route was identified in a region of the bladder trigone, incised, and probed witha urethral probe No. 04. The intramural course in the proximal urethra was identified and probed with a 16G epiduralcatheter. It was necessary to perform a neoureterostomy. A longitudinal incision (spatulation) of approximately 5 mm wasmade in the distal portion of the right ureter to increase the circumference of the...

Ureteral stent placement using a double J-catheter in the treatment of ectopic ureter in a dog

Background: Ectopic ureter is a congenital anomaly in which the final segment of one or both ureteral orifices is locateddistal to the bladder trigone. It may be classified as intra- or extramural. Surgical treatment of ectopic ureters in dogs isrecommended and the approach varies with the classification. In the postoperative period, complications are common.When stenosis of the new ureteral ostium occurs, immediate repeated surgery is recommended. This study aimed at usingthe double J catheter placement following neoureterostomy to treat urethral obstruction secondary to the surgical treatmentof an intramural ectopic ureter in a dog.Case: An 8-month-old female French bulldog with dysuria and urinary incontinence was seen at a private veterinaryhospital in Jaboticabal, São Paulo. The patient had previously been diagnosed with an intramural ectopic ureter on theright side following imaging tests (ultrasound, computed tomography, and abdominal radiography, excretory urography)and had undergone neoureterostomy and closure of the intramural pathway approximately a year ago. Ultrasonographicexamination showed dilation of the caudal portion of the ureter and hydroureter, which was suggestive of right ureteralstenosis. Computed tomography was also performed to evaluate the kidneys, ureters, and bladder; an increase in the diameter of the right ureter in its middle portion and close to the bladder triangle was observed. A new surgical interventionwas indicated and performed. The ureteral route was identified in a region of the bladder trigone, incised, and probed witha urethral probe No. 04. The intramural course in the proximal urethra was identified and probed with a 16G epiduralcatheter. It was necessary to perform a neoureterostomy. A longitudinal incision (spatulation) of approximately 5 mm wasmade in the distal portion of the right ureter to increase the circumference of the...(AU)

Simulated training model of ureteropyelic anastomosis in laparoscopic pyeloplasty

Purpose: To develop a model for simulated training of ureteropyelic anastomosis in laparoscopicpyeloplasty. Methods: Longitudinal and experimental study, with 16 participants. A synthetic instrument was produced to simulate the renal pelvis and the proximal portion of the ureter positioned on a platform within laparoscopic simulators, thereby resulting in the realistic simulation of the ureteropelvic anastomosis. A step-by-step guide was also developed for the accomplishment of the ureteropelvic anastomosis training model. Results: In the evaluation of all participants suture training, a decrease was found in the time needed to perform the anastomosis, with a median of 17.83 min in the 1st step and 14.21 min in the last one (p = 0.01). Regarding the knots, in the 1st step, 5% of them were considered firm, with an evolution to 30% in the last step (p = 0.011). Conclusion: We noticed improvement in the ability to perform the ureteropelvic anastomosis by participants with no experience with it. Therefore, even unexperienced participants can improve their skills with this training. Moreover, we observed the effectiveness of the model use, confirmed by the participants opinion and its validation by expert surgeons.(AU)

Ureterostomias cutânea e colônica em suínos: avaliação da exequibilidade das técnicas / Cutaneous ureterostomies in pigs: technical feasibility assessment

O aumento da expectativa de vida dos animais de companhia favorece a ocorrência de casos de câncer, como o de bexiga. O objetivo da presente pesquisa foi avaliar a exequibilidade da técnica de ureterostomia cutânea em suínos após a realização da cistectomia total, quando comparada à técnica de ureterostomia colônica, assim como detectar e caracterizar possíveis complicações transoperatórias. Foram utilizados 20 animais, distribuídos em dois grupos. Todos foram submetidos à cistectomia radical e, em seguida, à ureterostomia cutânea ou colônica. A exequibilidade das técnicas foi avaliada. Observou-se o tamanho da incisão, o tempo de diérese, de realização da derivação urinária e o tempo de síntese, estimou-se a perda sanguínea e o grau de dificuldade na realização dos procedimentos de preparo dos ureteres, o preparo do sítio de ureteroanastomose e a realização da ureteroanastomose em si. Os resultados indicam que a ureterostomia cutânea apresentou maior eficiência quando comparada à colônica nos quesitos perda de sangue, tamanho da incisão realizada e facilidade de realização da anastomose. Já a ureterocolostomia apresentou melhor resultado referente à execução do preparo ureteral. Assim, concluiu-se que ambas as técnicas podem ser indicadas como derivações urinárias viáveis e que a escolha dependerá de fatores intrínsecos ao cirurgião e ao paciente.(AU)

Increased life expectancy of pets favors the occurrence of cancer, such as the urinary bladder ones. The aim of this study was to evaluate the feasibility of cutaneous ureterostomy technique in pigs after the total cystectomy compared to the technique of colonic ureterostomy, as well as detect and characterize possible intraoperative complications. For that, 20 pigs were used, divided into two groups. All patients underwent radical cystectomy and then the cutaneous or colonic ureterostomies. The technical feasibility was assessed during the procedures. The procedures compared were: the incision size, dieresis time, realization of urinary diversion and the synthesis time. Also, the estimated blood loss and the degree of difficulty in performing the preparation procedures of the ureters, ureteroanastomose site preparation and ureteroanastomose itself were compared. The results indicate that performing cutaneous ureterostomy was better than the colonic ureterostomy in relation to blood loss, incision size, and anastomosis performance. In contrast, ureterocolonostomy showed better results on the implementation of ureteral preparation. Thus, it was concluded that both techniques can be indicated as viable urinary diversions and the choice will depend on factors intrinsic to the surgeon and the patient.(AU)

Ureterostomias cutânea e colônica em suínos: avaliação da exequibilidade das técnicas / Cutaneous ureterostomies in pigs: technical feasibility assessment

O aumento da expectativa de vida dos animais de companhia favorece a ocorrência de casos de câncer, como o de bexiga. O objetivo da presente pesquisa foi avaliar a exequibilidade da técnica de ureterostomia cutânea em suínos após a realização da cistectomia total, quando comparada à técnica de ureterostomia colônica, assim como detectar e caracterizar possíveis complicações transoperatórias. Foram utilizados 20 animais, distribuídos em dois grupos. Todos foram submetidos à cistectomia radical e, em seguida, à ureterostomia cutânea ou colônica. A exequibilidade das técnicas foi avaliada. Observou-se o tamanho da incisão, o tempo de diérese, de realização da derivação urinária e o tempo de síntese, estimou-se a perda sanguínea e o grau de dificuldade na realização dos procedimentos de preparo dos ureteres, o preparo do sítio de ureteroanastomose e a realização da ureteroanastomose em si. Os resultados indicam que a ureterostomia cutânea apresentou maior eficiência quando comparada à colônica nos quesitos perda de sangue, tamanho da incisão realizada e facilidade de realização da anastomose. Já a ureterocolostomia apresentou melhor resultado referente à execução do preparo ureteral. Assim, concluiu-se que ambas as técnicas podem ser indicadas como derivações urinárias viáveis e que a escolha dependerá de fatores intrínsecos ao cirurgião e ao paciente.(AU)

Increased life expectancy of pets favors the occurrence of cancer, such as the urinary bladder ones. The aim of this study was to evaluate the feasibility of cutaneous ureterostomy technique in pigs after the total cystectomy compared to the technique of colonic ureterostomy, as well as detect and characterize possible intraoperative complications. For that, 20 pigs were used, divided into two groups. All patients underwent radical cystectomy and then the cutaneous or colonic ureterostomies. The technical feasibility was assessed during the procedures. The procedures compared were: the incision size, dieresis time, realization of urinary diversion and the synthesis time. Also, the estimated blood loss and the degree of difficulty in performing the preparation procedures of the ureters, ureteroanastomose site preparation and ureteroanastomose itself were compared. The results indicate that performing cutaneous ureterostomy was better than the colonic ureterostomy in relation to blood loss, incision size, and anastomosis performance. In contrast, ureterocolonostomy showed better results on the implementation of ureteral preparation. Thus, it was concluded that both techniques can be indicated as viable urinary diversions and the choice will depend on factors intrinsic to the surgeon and the patient.(AU)

Estenose ureteral após cistectomia radical associada à ureterostomia cutânea abdominal: relato de caso / Ureteral stricture after radical cystectomy and cutaneous abdominal ureterostomy: case report

O presente trabalho tem como objetivo relatar a realização de cistectomia total associada à ureterostomia abdominal, uma técnica ainda pouco descrita na veterinária, bem como descrever as complicações pós-operatórias observadas. Um canino da raça Akita, macho, 11 anos, castrado, foi atendido com histórico de prostração, hiporexia, disúria, hematúria e incontinência urinária havia aproximadamente 10 dias. No exame clínico, foi observada leve algia abdominal; demais parâmetros estavam dentro da normalidade. Os exames complementares de imagem revelaram presença de massa envolvendo grande parte da vesícula urinária. O paciente foi submetido à cirurgia de cistectomia total associada à implantação cutânea abdominal dos ureteres, e o exame histopatológico chegou ao diagnóstico de carcinoma de células de transicionais (CCT) infiltrativo não papilar. No pós-operatório, o paciente desenvolveu dermatite urêmica leve no local de inserção dos ureteres e estenose ureteral em região distal, de maneira que reintervenções cirúrgicas foram necessárias para a correção. Além disso, observaram-se pielonefrite e hidronefrose secundárias ao quadro obstrutivo. Devido às complicações pós-operatórias, a tutora optou pela eutanásia do cão. Dessa maneira, conclui-se que a estenose ureteral e a pielonefrite são possíveis complicações da técnica de cistectomia associada à implantação abdominal dos ureteres.(AU)

This study aims to report the technique of total cystectomy associated with abdominal ureterostomy, a technique -little described in veterinary medicine, as well as to describe the postoperative complications observed. A male Akita canine, 11 years old, castrated, was attended with a history of prostration, hyporexia, dysuria, hematuria, and urinary incontinence for approximately ten days. The clinical examination revealed mild abdominal pain and other parameters within the normal range. Complementary imaging studies revealed the presence of mass involving a large part of the urinary bladder. The patient underwent total cystectomy surgery associated with abdominal cutaneous implantation of the ureters and histopathological examination led to a diagnosis of non-papillary infiltrative transitional cell carcinoma. In the postoperative period, the patient developed mild uremic dermatitis at the insertion site of the ureters and ureteral stenosis in the distal region, so that surgical reinterventions were necessary for correction. In addition, pyelonephritis and hydronephrosis secondary to the obstructive condition were observed. Due to the postoperative complications, the tutor chose to euthanize the dog. Thus, it is concluded that ureteral stenosis and pyelonephritis are possible complications of the cystectomy technique associated with abdominal implantation of the ureters.(AU)

Estenose ureteral após cistectomia radical associada à ureterostomia cutânea abdominal: relato de caso / Ureteral stricture after radical cystectomy and cutaneous abdominal ureterostomy: case report

O presente trabalho tem como objetivo relatar a realização de cistectomia total associada à ureterostomia abdominal, uma técnica ainda pouco descrita na veterinária, bem como descrever as complicações pós-operatórias observadas. Um canino da raça Akita, macho, 11 anos, castrado, foi atendido com histórico de prostração, hiporexia, disúria, hematúria e incontinência urinária havia aproximadamente 10 dias. No exame clínico, foi observada leve algia abdominal; demais parâmetros estavam dentro da normalidade. Os exames complementares de imagem revelaram presença de massa envolvendo grande parte da vesícula urinária. O paciente foi submetido à cirurgia de cistectomia total associada à implantação cutânea abdominal dos ureteres, e o exame histopatológico chegou ao diagnóstico de carcinoma de células de transicionais (CCT) infiltrativo não papilar. No pós-operatório, o paciente desenvolveu dermatite urêmica leve no local de inserção dos ureteres e estenose ureteral em região distal, de maneira que reintervenções cirúrgicas foram necessárias para a correção. Além disso, observaram-se pielonefrite e hidronefrose secundárias ao quadro obstrutivo. Devido às complicações pós-operatórias, a tutora optou pela eutanásia do cão. Dessa maneira, conclui-se que a estenose ureteral e a pielonefrite são possíveis complicações da técnica de cistectomia associada à implantação abdominal dos ureteres.(AU)

This study aims to report the technique of total cystectomy associated with abdominal ureterostomy, a technique -little described in veterinary medicine, as well as to describe the postoperative complications observed. A male Akita canine, 11 years old, castrated, was attended with a history of prostration, hyporexia, dysuria, hematuria, and urinary incontinence for approximately ten days. The clinical examination revealed mild abdominal pain and other parameters within the normal range. Complementary imaging studies revealed the presence of mass involving a large part of the urinary bladder. The patient underwent total cystectomy surgery associated with abdominal cutaneous implantation of the ureters and histopathological examination led to a diagnosis of non-papillary infiltrative transitional cell carcinoma. In the postoperative period, the patient developed mild uremic dermatitis at the insertion site of the ureters and ureteral stenosis in the distal region, so that surgical reinterventions were necessary for correction. In addition, pyelonephritis and hydronephrosis secondary to the obstructive condition were observed. Due to the postoperative complications, the tutor chose to euthanize the dog. Thus, it is concluded that ureteral stenosis and pyelonephritis are possible complications of the cystectomy technique associated with abdominal implantation of the ureters.(AU)

Ureter ectópico extramural em um cão Labrador Retriever: relato de caso / Ectopic ureter extramural in a Labrador Retriever dog: a case report

A ectopia ureteral é uma enfermidade congênita que se caracteriza quando um ou ambos os ureteres apresentam-se inseridos fora do seu local anatômico, com a inserção ocorrendo no útero, no colo da bexiga, na uretra ou na vagina, devido a uma diferenciação anormal dos ductos mesonéfricos e metanéfricos. Nos machos, a inserção pode ocorrer também nos ductos deferentes e na próstata. A incontinência urinária é o sinal clínico mais comumente associado ao ureter ectópico. O presente relato descreve um caso de ureter ectópico extramural unilateral, em um cão da raça Labrador Retriever de sete anos de idade, corrigido cirurgicamente, e mostra a importância dos exames radiográfico contrastado e ultrassonografia.(AU)

Ureteral ectopia is a congenital disease that is characterized when one or both ureters are shown inserted outside their anatomic site, with the possible insertion in the uterus, bladder neck, the urethra or vagina due to abnormal differentiation of ducts mesonephrics and metanephrics. In males the insertion can also occur in the vas deferens and prostate. Urinary incontinence is the most common clinical sign associated with ectopic ureter. This report describes a case of unilateral extramural ectopic ureter in a dog of the Labrador Retriever breed at seven years old surgically corrected, and shows the importance of contrast radiographic examination and ultrasound.(AU)

Ureter ectópico extramural em um cão Labrador Retriever: relato de caso / Ectopic ureter extramural in a Labrador Retriever dog: a case report

A ectopia ureteral é uma enfermidade congênita que se caracteriza quando um ou ambos os ureteres apresentam-se inseridos fora do seu local anatômico, com a inserção ocorrendo no útero, no colo da bexiga, na uretra ou na vagina, devido a uma diferenciação anormal dos ductos mesonéfricos e metanéfricos. Nos machos, a inserção pode ocorrer também nos ductos deferentes e na próstata. A incontinência urinária é o sinal clínico mais comumente associado ao ureter ectópico. O presente relato descreve um caso de ureter ectópico extramural unilateral, em um cão da raça Labrador Retriever de sete anos de idade, corrigido cirurgicamente, e mostra a importância dos exames radiográfico contrastado e ultrassonografia.(AU)

Ureteral ectopia is a congenital disease that is characterized when one or both ureters are shown inserted outside their anatomic site, with the possible insertion in the uterus, bladder neck, the urethra or vagina due to abnormal differentiation of ducts mesonephrics and metanephrics. In males the insertion can also occur in the vas deferens and prostate. Urinary incontinence is the most common clinical sign associated with ectopic ureter. This report describes a case of unilateral extramural ectopic ureter in a dog of the Labrador Retriever breed at seven years old surgically corrected, and shows the importance of contrast radiographic examination and ultrasound.(AU)

Ureterorrafia microcirúrgica: consolidação da técnica

As obstruções ureterais felinas têm apresentado uma crescente incidência na prática clínica veterinária e podem ter o diagnóstico e tratamento complexos. Vários tratamentos cirúrgicos têm sido descritos para o alívio das obstruções ureterais felinas ao longo dos anos, e, apesar de a ureterotomia microcirúrgica ser apontada como um dos tratamentos mais eficazes, esta ainda está associada a altas taxas de complicações pós-operatórias e de mortalidade. Isto ocorre devido à escassez de pesquisas que correlacionem o pequeno diâmetro ureteral aos calibres dos fios de sutura mais adequados e materiais que causem menor reação tecidual, evitando complicações pós-operatórias como extravasamento urinário, fibrose e estenose. O objetivo é estabelecer o material e o diâmetro do fio de sutura mais adequado para a realização da ureterorrafia microcirúrgica. Através de comparações por meio de exames ultrassonográficos em dois tempos, além de avaliações macroscópicas e microscópicas, foi possível observar que os fios de sutura com calibre 10-0 causam menores alterações renais e ureterais no local da sutura e que o material náilon é eficaz para este procedimento mesmo se tratando de um fio inabsorvível em trato urinário. Nos calibres mais grosseiros como 6-0 e 8-0, os melhores resultados estão associados ao fio absorvível. Conclui-se que a utilização de fios mais finos, acoplados a agulhas atraumáticas e utilizando magnificação cirúrgica adequada possibilitam uma sutura ureteral mais precisa, reduzindo o dano tecidual e complicações associadas ao procedimento cirúrgico.

Feline ureteral obstructions have shown an increasing incidence in veterinary clinical practice and can have complex diagnosis and treatment. Several surgical treatments have been described for the relief of feline ureteral obstructions over the years and although microsurgical ureterotomy is considered one of the most effective treatments, it is still associated with high rates of postoperative complications and mortality. This is due to the scarcity of research that correlates the small ureteral diameter to the gauges of the most appropriate sutures and materials that cause less tissue reaction, avoiding postoperative complications such as urinary leakage, fibrosis and stenosis. The objective is to establish the material and the diameter of the most appropriate suture for performing microsurgical ureterorrhaphy. Through comparisons by means of two-stage ultrasound examinations, in addition to macroscopic and microscopic evaluations, it was possible to observe that 10-0 gauge sutures cause less renal and ureteral changes at the suture site and that the nylon material is effective for this procedure even if it is an absorbable thread in the urinary tract. In the coarsest calibers like 6-0 and 8-0, the best results are associated with the absorbable thread. It is concluded that the use of thinner threads, coupled with atraumatic needles and using appropriate surgical magnification allow a more accurate ureteral suture, reducing tissue damage and complications associated with the surgical procedure.

Structural changes of dilated pelvic ureters in adults

To perform a quantitative assessment of different types of pelvic ureter tissues with chronic dilation in adults, using stereological methods. We analyzed fragments of dilated pelvic ureters obtained from 6 patients aged between 35 and 67 years (mean, 46 years) who underwent ureteral reimplantation surgery for different reasons. The obstruction duration ranged from 27 to 180 days (mean, 93 days). The control group included fragments of normal pelvic ureters obtained during nephrectomy in 7 kidney transplant donors (age: range, 25-51 years; mean, 36 years). The volumetric density of collagen in the ureter, elastic fibers, and smooth muscle fibers was assessed. The volumetric density (Vv) of collagen showed no significant difference between the two groups (control: 45.3 ± 6.1; dilated: 40.8 ± 6.9; P = 0.23). A statistically significant increase in Vv of elastic fibers was observed in the dilated ureters (control: 18.4 ± 1.2; dilated: 24.6 ± 5.4; P = 0.03). A statistically significant increase in the Vv of smooth muscle fibers was observed in the dilated ureter (control: 42.0 ± 6.0; dilated: 56.2 ± 6.1; P = 0.001). The chronically dilated pelvic ureters had significantly more elastin and smooth muscle contents than the controls.(AU)

Ectopia ureteral bilateral em cadelas: diagnóstico, tratamento cirúrgico e evolução clínica / Bilateral Ureteral Ectopia in Female Dogs: Diagnosis, Surgical Treatment, and Clinical Outcomes

Background: Ectopic ureter is the most common cause of congenital urinary incontinence in dogs. Intramural ectopic ureter occurs when the ureter runs within the urinary bladder wall, while extramural ectopic ureter occurs when the distal ureter is not associated with the bladder wall. Ectopic ureters are diagnosed using different techniques and/or combinations of various imaging studies. Surgical correction is the standard treatment for dogs with an ectopic ureter, and these surgical techniques include neoureterostomy, ureteroneocystostomy, and nephroureterectomy. The aim of this report is to describe two cases of ectopic ureter successfully treated with surgery. Cases: In case 1, a 2-month-old female poodle, weighing 1.3 kg, with urinary incontinence since birth was presented to our veterinary service. Excretory urography revealed an ectopic ureter, and ureteroneocystostomy was performed. Abdominal ultrasonography performed 30 days after surgery revealed left renal pyelectasis and ureteral dilatation. Based on these findings, nephrectomy was performed. In case 2, a 3-month-old Golden Retriever, weighing 13.5 kg, with urinary incontinence since birth was brought to our veterinary service. Abdominal ultrasonography revealed a small left kidney and left ureteral dilation. Laparotomy was performed and revealed bilateral intramural ectopic ureters. Based on these findings, bilateral neoureterostomy was performed. Thirty days after surgery, patient presented with urinary infection that was controlled with antibiotics. Both dogs were continent one year after treatment. Discussion: Imaging results of the urinary tract can be useful in diagnosing ectopic ureter. Image modalities used for detecting ectopic ureter include excretory urography, pneumocystography, vaginography, retrograde urethrography, ultrasonography, computed tomography, and magnetic resonance imaging. The difference between extra and intramural ureteral ectopia, in some cases, can only be determined during exploratory laparotomy. Surgical complications vary due to several factors, such as whether the ureteral ectopia is uni- or bilateral, intra or extramural, and also the surgical treatment used. Ureteroneocystostomy complications include hydroureter, hydronephrosis, cystitis, transient stenosis, anastomotic dehiscence, persistent dysuria, and loss of normal ureteric peristalsis. Complications of neoureterostomy include persistent dysuria, cystitis, and reflex dyssynergia. Recanalization is a possible cause of postoperative incontinence if the distal ureter is not completely resected. Unilateral hydronephrosis was observed in the first reported case, and nephroureterectomy was performed. A nephroureterectomy is indicated when severe pathologic findings are present, such as severe hydronephrosis, hydroureter, or renal dysplasia and when the contralateral kidney and ureter are functioning normally. In the second case, bacterial cystitis was diagnosed during the post-operative period and was controlled with antibiotic therapy. After surgery, 44­67% of dogs had persistent urinary incontinence. Although residual incontinence can occur after incomplete intramural ureteral remnant or ureteral trough resection, incontinence has also been reported after ureteral reimplantation and nephroureterectomy. Bilateral disease and concurrent urogenital abnormalities often contribute to treatment failure. Therapeutic success was reported in both cases without signs of urinary incontinence one year after surgery.

Bilateral ureteral ectopia in female dogs: diagnosis, surgical treatment, and clinical outcomes / Ectopia ureteral bilateral em cadelas: diagnóstico, tratamento cirúrgico e evolução clínica

Background: Ectopic ureter is the most common cause of congenital urinary incontinence in dogs. Intramural ectopic ureter occurs when the ureter runs within the urinary bladder wall, while extramural ectopic ureter occurs when the distal ureter is not associated with the bladder wall. Ectopic ureters are diagnosed using different techniques and/or combinations of various imaging studies. Surgical correction is the standard treatment for dogs with an ectopic ureter, and these surgical techniques include neoureterostomy, ureteroneocystostomy, and nephroureterectomy. The aim of this report is to describe two cases of ectopic ureter successfully treated with surgery. Cases: In case 1, a 2-month-old female poodle, weighing 1.3 kg, with urinary incontinence since birth was presented to our veterinary service. Excretory urography revealed an ectopic ureter, and ureteroneocystostomy was performed. Abdominal ultrasonography performed 30 days after surgery revealed left renal pyelectasis and ureteral dilatation. Based on these fi ndings, nephrectomy was performed. In case 2, a 3-month-old Golden Retriever, weighing 13.5 kg, with urinary incontinence since birth was brought to our veterinary service. Abdominal ultrasonography revealed a small left kidney and left ureteral dilation. Laparotomy was performed and revealed bilateral intramural ectopic ureters. Based on these findings, bilater

Background: Ectopic ureter is the most common cause of congenital urinary incontinence in dogs. Intramural ectopic ureter occurs when the ureter runs within the urinary bladder wall, while extramural ectopic ureter occurs when the distal ureter is not associated with the bladder wall. Ectopic ureters are diagnosed using different techniques and/or combinations of various imaging studies. Surgical correction is the standard treatment for dogs with an ectopic ureter, and these surgical techniques include neoureterostomy, ureteroneocystostomy, and nephroureterectomy. The aim of this report is to describe two cases of ectopic ureter successfully treated with surgery. Cases: In case 1, a 2-month-old female poodle, weighing 1.3 kg, with urinary incontinence since birth was presented to our veterinary service. Excretory urography revealed an ectopic ureter, and ureteroneocystostomy was performed. Abdominal ultrasonography performed 30 days after surgery revealed left renal pyelectasis and ureteral dilatation. Based on these fi ndings, nephrectomy was performed. In case 2, a 3-month-old Golden Retriever, weighing 13.5 kg, with urinary incontinence since birth was brought to our veterinary service. Abdominal ultrasonography revealed a small left kidney and left ureteral dilation. Laparotomy was performed and revealed bilateral intramural ectopic ureters. Based on these findings, bilater

Ectopia ureteral unilateral congênita em uma cadela Teckel Dachshund com pelagem arlequim: relato de caso / Single congenital ureteral ectopy in a female dog Teckel Dachshund with merle colour pattern: case report

O presente relato apresenta a primeira descrição de ectopia ureteral congênita na raça Teckel Dachshund, diagnosticada em uma cadela com pelagem arlequim. O animal, aos dois meses de idade, apresentava sinais de incontinência urinária e cistite bacteriana, sendo submetido a um plano diagnóstico para confirmação de ureter ectópico. A urografia excretora revelou hidroureter direito com desembocadura caudal ao trígono da bexiga. O exame físico do animal evidenciou ainda hérnia inguinal bilateral, o que reforçou a caracterização da origem congênita das alterações. Aspectos de bem-estar animal são também discutidos.(AU)

The present work reports the first description of congenital ureteral ectopy in the canine breed Teckel Dachshund, diagnosed in a female dog with merle colour pattern. The two month old animal, presented with continuous dribbling of urine and bacterial cystitis, was subjected to a diagnostic plan for ectopic ureter. The excretory urography showed a right hidroureter, which had an orifice located caudally to the trigone of the bladder. The animal also presented a bilateral inguinal hernia, which confirmed the case description as a multiple congenital anomaly condition. Animal welfare aspects are also discussed.(AU)

Ureterocele ortotópica em cadela (Canis familiaris) - relato de caso / Orthotopic ureterocele in bitch (Canis familiaris) - a case report / Ureterocele ortotópico en perra (Canis familiaris) - relato de caso

A ureterocele é uma dilatação da porção final do ureter decorrente de falha embriológica sem causa ainda definida. Foi atendida uma cadela da raça poodle de três meses de idade com queixa de incontinência urinária. Os exames de imagem foram os responsáveis pelo fechamento do diagnóstico, sendo visualizada uma dilatação cística intravesical. A técnica cirúrgica utilizada foi a ressecção da ureterocele com marsupialização das bordas, obtendo-se remissão completa dos sinais clínicos dois meses após a cirurgia. Aos dois anos de idade, a cadela permanece continente.

Ureterocele is a dilation of the final portion of the ureter, which results from an embryological failure of unknown cause. This article describes the case of a three-month-old female poodle with complaints of urinary incontinence. Imaging exams helped establish the diagnosis by disclosing an orthotopic cystic dilation. The surgical technique employed to treat the condition was resection of the ureterocele with marsupialization of the edges. Complete remission of clinical signs was achieved two months post-surgery; the dog remains continent two years after the procedure.

El ureterocele es una dilatación de la porción final del uréter provocado por una falla en su desarrollo embriológico, cuya causa aún no ha sido definida. Se atendió una perra Caniche de tres meses con cuadro de incontinencia urinaria. Los exámenes de imagen, a través de los cuales se pudo llegar al diagnóstico de la enfermedad, permitieron comprobar la presencia de una dilatación quística en el lumen vesical. En la cirugía se realizó la resección del ureterocele y marsupialización de los bordes; dos meses después de realizada la cirugía, el paciente no presentaba cuadros de incontinencia. A los dos años de edad, la perra permanece sin síntomas.

Ureterocele ortotópica em cadela (Canis familiaris) - relato de caso / Orthotopic ureterocele in bitch (Canis familiaris) - a case report / Ureterocele ortotópico en perra (Canis familiaris) - relato de caso

A ureterocele é uma dilatação da porção final do ureter decorrente de falha embriológica sem causa ainda definida. Foi atendida uma cadela da raça poodle de três meses de idade com queixa de incontinência urinária. Os exames de imagem foram os responsáveis pelo fechamento do diagnóstico, sendo visualizada uma dilatação cística intravesical. A técnica cirúrgica utilizada foi a ressecção da ureterocele com marsupialização das bordas, obtendo-se remissão completa dos sinais clínicos dois meses após a cirurgia. Aos dois anos de idade, a cadela permanece continente.(AU)

Ureterocele is a dilation of the final portion of the ureter, which results from an embryological failure of unknown cause. This article describes the case of a three-month-old female poodle with complaints of urinary incontinence. Imaging exams helped establish the diagnosis by disclosing an orthotopic cystic dilation. The surgical technique employed to treat the condition was resection of the ureterocele with marsupialization of the edges. Complete remission of clinical signs was achieved two months post-surgery; the dog remains continent two years after the procedure. (AU)

El ureterocele es una dilatación de la porción final del uréter provocado por una falla en su desarrollo embriológico, cuya causa aún no ha sido definida. Se atendió una perra Caniche de tres meses con cuadro de incontinencia urinaria. Los exámenes de imagen, a través de los cuales se pudo llegar al diagnóstico de la enfermedad, permitieron comprobar la presencia de una dilatación quística en el lumen vesical. En la cirugía se realizó la resección del ureterocele y marsupialización de los bordes; dos meses después de realizada la cirugía, el paciente no presentaba cuadros de incontinencia. A los dos años de edad, la perra permanece sin síntomas.(AU)

Ectopia ureteral em cães: relato de dois casos / Urethral ectopia in dogs: report of two cases / Ectopia uretral en perros: relato de dos casos

O presente trabalho descreve dois casos distintos de ectopia ureteral em cães atendidos no Hospital de Medicina Veterinária da Universidade Federal da Bahia. O primeiro relata a presença de ureter ectópico intramural unilateral direito em uma cadela da raça poodle, de aproximadamente um ano de idade, que apresentava como sequela a hidronefrose e hidroureter, sendo necessária a ureteronefrectomia direita para resolução do caso. O segundo caso refere-se à presença de ureter ectópico extramural bilateral em uma cadela da raça Husky Siberiano, de seis anos de idade, cujo prognóstico foi desfavorável em virtude de alterações irreversíveis em todo trato urinário. Em ambos os casos, evidenciou-se a importância do diagnóstico precoce para evitar o desencadeamento de sequelas e garantir a resolução do problema.(AU)

This study describes two distinct cases of urethral ectopia in dogs examined at the Veterinary Hospital of the Federal University of Bahia. The first one reports the presence of a right unilateral intramural ectopic ureter in a one-year-old female Poodle that had hydro nephrosis and hydro ureter and that needed right ureter nephrectomy to solve the problem The second case is the presence of a bilateral extramural ectopic ureter in a six-year-old female Siberian Husky whose prognostic was unfavorable due to irreversible alterations throughout the urinary tract. In both cases, it was evident how important an early diagnostic is to avoid sequelae and ensure the problem solution.(AU)

Este estudio describe dos casos distintos de ectopia uretral en perros atendidos en el Hospital de Medicina Veterinario de la Universidad Federal de Bahía. El primer caso relata la presencia de uréter ectópico intramural unilateral derecho, en una perra de la raza poodle, de aproximadamente un año de edad, que presentaba como secuela la hidronefrosis e hidrouréter, haciéndose necesario la ureteronefrectomia derecha para resolución del caso. El segundo caso se refiere a presencia de uréter ectópico extramural bilateral en una perra de la raza Husky Siberiano, de seis años de edad, cuyo pronóstico fue desfavorable en virtud de alteraciones irreversibles en todo tracto urinario. En los dos casos, se evidenció la importancia del diagnóstico precoz para evitar el desencadenamiento de secuelas y garantizar la resolución del problema.(AU)

Ocorrência simultânea de urolitíase renal, ureteral e vesical emuma cadela: relato de caso / Simultaneous renal, ureteral, and vesical urolithiasis in a bitch: case report

Urolitiase é a formação de cálculos em uma ou mais porções do trato urinário, sendo sua incidênciainfluenciada por uma série de fatores. Este artigo relata o caso de uma cadela com histórico de disúria,hematúria e piúria devido à presença de cálculos renal, vesical e ureteral. A cirurgia é o tratamento de eleição e foi bem sucedida, mas deve ser associada ao tratamento médico adequado para evitar recidivas e possibilitar boa qualidade de vida ao paciente.(AU)

Urolithiasis is the calculi formation in the urinary tract and it is influenced by several factors. This paper describes the case of a bitch with history of dysuria, hematuria and pyuria due to renal, ureteral, and vesical calculi. Surgical treatment was successful but appropriate medical treatment is important to preventrecurrence and allow good life quality to the patient.(AU)