Use of monopolar cauterization by cystoscopy for ectopic intramural ureter correction in a bitch

ABSTRACT

Background: The ectopic ureter (EU) is considered a congenital anomaly in which the ureteral aperture opens in a positionother than the bladder neck. The diagnosis involves the use of different methods or combination of image exams, including excretory urography, pneumocystography, ultrasonography, cystoscopy and computed tomography. The technics forsurgical repair should be considered evaluating the number and functionality of the EU, the location of the ureteral opening, functional condition of ipsilateral kidney and the presence of other abnormalities. The case reports aims to show thesurgical repair of an intramural EU in an English Bulldog bitch by cystoscopy-guided monopolar cautery.Case A 1-year-old English Bulldog bitch received medical care due to a history of urinary incontinence since a few monthsof life. The animal had laboratory abnormalities compatible with lower urinary tract infection, followed by a profoundgrowth of Klebsiella sp in urine culture, and received antibiotic treatment for 21 days based on antibiogram results. Dueto a suspect EU, a urinary tract tomography was performed and indicated a congenital kidney malformation (renal dysplasia), enlargement and distal insertion of the left ureter (in comparison with the contralateral one), rising suspiciously ofits intramural progression. We choose to proceed to cystoscopy examination, in which both right and left ureteral ostiumcould be seen in the urethral region. A guide of a pigtail catheter was inserted through both ureteral ostia in order to orientthe ureteral incision. The monopolar cautery was inserted in cystoscopy working channel to section the mucosa of EUchannel on urethra region, separating the lumen of EU from the urethra and extending the incision cranially inside theurinary bladder lumen. After a complete section of the ectopic tissue, a pigtail urinary catheter was correctly placed inboth ureters...