Placement of an artificial urethral sphincter for treatment of passive urinary incontinence after inadvertent prostatectomy and balloon dilation treatment for stricture formation in a 5-month-old dog.

OBJECTIVE: Describe the management of incontinence with several therapies, culminating with the apparently successful treatment utilizing artificial sphincter placement following an inadvertent prostatectomy. ANIMAL: 5-month-old 7.5-kg male neutered Miniature Schnauzer. CLINICAL PRESENTATION, PROGRESSION, AND PROCEDURES: The patient was referred for dysuria and persistent stranguria following an iatrogenic total prostatectomy and urethrectomy. An extra pelvic urethral anastomosis was performed, followed by hospitalization for 2 weeks with a urinary catheter. The patient was further investigated for persistent stranguria, and a contrast urethrogram revealed a urethral stricture at the anastomosis site, which was treated with fluoroscopic balloon dilation. The stranguria resolved, but an acute nocturnal grade 3 passive urinary incontinence occurred, which was nonresponsive to medical management of phenylpropanolamine hydrochloride and estriol. An artificial urethral sphincter was placed, leading to continence after 5 top-ups to a total volume of 0.9 mL. The patient remained continent for 5.5 weeks before abrupt incontinence recurred, which was resolved by another 0.1-mL top-up. No further signs of incontinence occurred in the 11 months following. TREATMENT AND OUTCOME: The placement of an artificial urethral sphincter successfully managed urinary incontinence in this patient. Continence was achieved with no significant complications other than a transient loss of continence. Long-term follow-up 14 months after sphincter placement revealed that the patient had remained continent since the final sphincter top-up. The owner reported a significant improvement in the patient's quality of life following successful incontinence management. CLINICAL RELEVANCE: This case highlighted the benefits of placing an artificial urethral sphincter in managing urinary incontinence after select cases of prostatectomy in dogs that are unresponsive to medical management.

Diagnosis of traumatic urethral stricture in a canine patient with contrast-enhanced voiding urosonography : A case report.

A 5-year-old intact male mixed-breed dog presented with a 3-day history of stranguria and dysuria. Results of physical examination, plain radiographs, and ultrasonography were consistent with a traumatic urethral stricture in the prescrotal urethra just under the previous trauma region, resulting in partial obstruction of urine outflow. Contrast-enhanced voiding urosonography (CE-VUS) was performed, and a urethral stricture was confirmed. The dog underwent surgery. A scrotal urethrostomy was performed. After 3 days of hospitalization, the dog was discharged from the Clinic. Based on an extensive literature review, this is the first report using CE-VUS to evaluate urethral pathology in a canine patient.

Management of obstructive urethroliths, urethral pseudodiverticulum, and stricture by diverticulectomy, urethroplasty, and urethral stenting placement in a male goat.

A 5-year-old wether was presented for an acute onset of loss of appetite and inability to urinate. Urethral urolithiasis causing urethral obstruction was diagnosed and a cystostomy catheter was placed. The wether continued to be unable to urinate through the urethra and further developed a perineal pseudodiverticulum. Diverticulectomy followed by a urethroplasty using porcine small intestinal submucosa was performed to relieve the obstruction. The wether developed a urethral stricture following urethroplasty and the owners refused a perineal urethroplasty. Cystourethrography, fluoroscopic-guided balloon dilations, and urethral stent placement were done to establish urethral patency. The wether developed tissue ingrowth through the stent, resulting in recurrent obstruction that necessitated placement of covered urethral stents. Key clinical message: Although obstructive uroliths usually carry a guarded prognosis in small ruminants, the use of novel interventional radiology techniques along with urethroplasty using a xenograft allowed a wether to achieve urethral patency and normal urinations.

Prise en charge d'un bouc présentant des urétrolithes osbtructifs, un pseudodiverticule urétral et une stricture par diverticulectomie, urétroplastie et placement d'un stent urétral. Un bouc castré de 5 ans a été présenté pour une perte aigüe d'appétit et une incapacité à uriner. Un calcul urétral provoquant une obstruction urinaire a été diagnostiquée et une sonde de cystotomie placée. Le bouc a continué d'être incapable d'uriner pas son urètre et a développé un pseudodiverticule périnéal. Une diverticulectomie suivie d'une urétroplastie utilisant de la sous-muqueuse d'intestin grêle de porc a été réalisée pour soulager l'obstruction. Le bouc a développé une stricture urétrale à la suite de l'urétroplastie et les propriétaires ont refusé une urétroplastie périnéale. Une cystourétrographie, des dilatations par ballonnets guidées par fluoroscopie ainsi que le placement d'un stent urétral ont été réalisés afin de résoudre l'obstruction urétrale. Le bouc a développé une réaction tissulaire envahissant la lumière du stent, entrainant ainsi une nouvelle obstruction et nécessitant la mise en place de stents urétraux couverts.Message clinique clé :Bien que les urolithes obstructifs aient généralement un pronostic réservé chez les petits ruminants, l'utilisation de nouvelles procédures provenant de la médecine interventionnelle associées à une urétroplastie utilisant une xénogreffe a permis d'obtenir une perméabilité de son urètre et des mictions normales chez ce bouc.(Traduit par les auteurs).

Neourethra creation using autologous vascularized intestinal graft in cats.

The objective of this study was to assess the application of a urethrostomy technique that utilizes an autologous vascularized intestinal graft as a "neourethra" and to analyze its short- and long-term feasibilities. Six cats with urethral rupture and 8 cats with urethral stricture and a history of urethrostomy were included. The inclusion criteria were the indication for urethroplasty and limited urethral length for perineal urethrostomy. A segment of intestine was prepared as a graft for urethral repair. The diameter of the aboral end was adjusted to facilitate anastomosis with the urethra or neck of the urinary bladder. An ostomy was created in the prepubic region using the oral end. The postoperative follow-up period was at least 1 y. Restoration of urinary flow was successful in all cases immediately after surgery. During postoperative follow-up, minimal complications were observed, with urinary incontinence being one of the most frequent, occurring in 28.5% (4/14) of the cases. Urine culture, carried out at different times during the follow-up period, was positive in 72.7% (8/11) of the cats. The autologous graft from the vascularized intestinal segment was an appropriate urethral substitute and this urethroplasty technique therefore proved to be feasible in cats. The postoperative complications observed were not exclusive to this technique and generally could either be corrected or tolerated. Periodic clinical follow-up examinations are recommended. This procedure allows the reestablishment of urinary flow and should be considered a favorable option, particularly when there is insufficient urethral tissue to allow repair using conventional techniques.

L'objectif de cette étude était d'évaluer l'application d'une technique d'urétrostomie qui utilise une greffe intestinale vascularisée autologue comme « néo-urètre ¼ et d'analyser ses faisabilités à court et à long terme. Six chats avec rupture urétrale et huit chats avec rétrécissement urétral et antécédents d'urétrostomie ont été inclus. Les critères d'inclusion étaient l'indication d'urétroplastie et la longueur urétrale limitée pour l'urétrostomie périnéale. Un segment d'intestin a été préparé comme greffon pour la réparation urétrale. Le diamètre de l'extrémité aborale était ajusté pour faciliter l'anastomose avec l'urètre ou le col de la vessie. Une stomie a été créée dans la région prépubienne en utilisant l'extrémité orale. La période de suivi postopératoire était d'au moins 1 an. La restauration du flux urinaire a réussi dans tous les cas immédiatement après la chirurgie. Au cours du suivi postopératoire, des complications minimes ont été observées, l'incontinence urinaire étant l'une des plus fréquentes, survenant dans 28,5 % (4/14) des cas. La culture urinaire, réalisée à différents moments de la période de suivi, était positive chez 72,7 % (8/11) des chats. La greffe autologue du segment intestinal vascularisé était un substitut urétral approprié et cette technique d'urétroplastie s'est donc avérée réalisable chez le chat. Les complications postopératoires observées n'étaient pas exclusives à cette technique et pouvaient généralement être soit corrigées soit tolérées. Des examens de suivi clinique périodiques sont recommandés. Cette procédure permet le rétablissement du flux urinaire et doit être considérée comme une option favorable, en particulier lorsque le tissu urétral est insuffisant pour permettre une réparation à l'aide de techniques conventionnelles.(Traduit par Docteur Serge Messier).

Preputial urethrostomy with preservation of the local anatomy in 4 dogs.

OBJECTIVE: To describe a novel modified preputial urethrostomy with preservation of the local anatomy in 4 dogs. STUDY DESIGN: Short case series. ANIMALS: Four client-owned male dogs. METHODS: Dogs presented for dysuria and urethral obstruction and underwent a modified preputial urethrostomy as a salvage procedure after the failure of previous treatments. Urethral stenosis or tear was confirmed by cysto-urethrography in all dogs. The preputial urethrostomy involved anastomosis of the pelvic urethra with the preputial mucosa after caudal laparotomy, without dissection of the prepuce or amputation of the penis. Owner follow up was obtained by telephone interview. RESULTS: Urinary obstruction was due to urethral stenosis in 3 dogs and severe complications following perineal urethrostomy in 1 dog. The urinary obstruction was resolved in all dogs by the modified preputial urethrostomy. None of the dogs had signs of dysuria, urinary tract infection, or dermatitis immediately postoperatively. Two dogs showed signs of urinary incontinence from 15 days to 1 month postoperatively, which persisted throughout the follow-up period. CONCLUSION: A functional urethral stoma was obtained in all dogs. This technique may be an alternative to prepubic urethrostomy in male dogs.

Transpelvic urethrostomy in a female dog with congenital vestibulovaginal and urethral stenosis: A case report.

OBJECTIVE: To describe transpelvic urethrostomy (TPU) as a surgical technique for the successful treatment of vestibulovaginal and urethral stenosis in a 7 month old female spayed mixed-breed dog. STUDY DESIGN: Case report. SAMPLE POPULATION: Female spayed mixed-breed dog with obstructive vaginal tissue present on vaginal examination. METHODS: The dog presented with a history of persistent urine dribbling, stranguria, and dysuria since birth. Vaginoscopy and fluoroscopy revealed severe vestibulovaginal and urethral stenosis. An episiotomy and partial vaginectomy were performed to remove stenotic tissue. A perineal urethrostomy was attempted from a blind-ended pouch associated with the stenotic urethral tissue but was unsuccessful. The dog was repositioned in dorsal recumbency and a postpubic urethrostomy was performed. RESULTS: Six days postoperatively, incisional dehiscence occurred at the cranial aspect of the urethrostomy. The site was revised at this location using a TPU to decrease tension at the urethrostomy site. The dog recovered uneventfully with no further complications identified after surgery. Forty-two months after surgical intervention, the dog continued to show no clinical signs. CONCLUSION: Transpelvic urethrostomy may be a viable surgical alternative for dogs diagnosed with urethral stenosis.

Buccal mucosal graft urethroplasty in male cats with traumatic complete urethral rupture.

OBJECTIVE: To evaluate the feasibility of buccal mucosal graft urethroplasty for repairing complete urethral rupture in cats. ANIMALS: 15 male domestic shorthair cats with traumatic complete urethral rupture. PROCEDURES: In each cat, a section of buccal mucosa was harvested, sutured, and formed into a tubule by use of an 8F indwelling catheter as support. This tubular graft was connected to both ruptured ends of the urethra to renew the urinary passage. The catheter was left in place until the absence of leakage was confirmed by positive contrast retrograde urethrography. After spontaneous urination was confirmed, cats were discharged from the hospital. Six months later, urethrography was repeated and owners were asked to score their cats' urinary function and quality of life. RESULTS: 13 cats recovered well following surgery, with no complications in the oral cavity or surgical site and no signs of difficulty or discomfort when urinating. Urethrography 2 weeks and 6 months after surgery revealed no stricture or leakage in the abdominal cavity. The 2 remaining cats developed a urethral stricture and underwent second surgery with a successful outcome. At the 6-month follow-up, 14 cats had only mild urinary signs, and 1 cat had incontinency. Owners indicated they were delighted (n = 14) or pleased (1) with their cats' quality of life. CLINICAL RELEVANCE: Buccal mucosa was found to be a good source of graft tissue for performance of urethroplasty in male cats, yielding satisfactory outcomes with few postoperative complications. The described technique may be suitable for severe and complicated cases of urethral rupture in male cats.

Midbody penile urethrocutaneous fistula repaired by fistulectomy and urethral anastomosis in a stallion.

CASE DESCRIPTION: A 12-year-old Friesian stallion was examined because of a 1-year history of preputial injury and urination through a urethrocutaneous fistula located at the midbody of the ventral aspect of the penis. CLINICAL FINDINGS: Physical examination revealed an opening with a clearly apparent mucocutaneous junction 12 cm from the distal opening of the urethra on the ventral left side of the penis. Endoscopic examination of the distal portion of the urethra confirmed a blind pouch with no communication with the fistula or proximal portion of the urethra. TREATMENT AND OUTCOME: A temporary perineal urethrostomy was performed with sedation and local anesthesia, with the stallion standing, to divert urine from the urethral reconstruction site. Fistulectomy and urethral resection and anastomosis were performed under general anesthesia with the stallion in dorsal recumbency. At 15 days after surgery, endoscopic examination of the urethra revealed distortion of the urethral lumen at the fistulectomy site. Under sedation, the urethra was dilated for 5 minutes every 12 hours for 3 days. At 22 days after surgery, endoscopic examination of the urethra revealed a healed anastomosis site and a large urethral luminal diameter. At 36 months after surgery, the owner reported that the stallion had normal micturition and had sired multiple foals by live cover matings. CLINICAL RELEVANCE: Severe preputial or penile trauma in horses is most commonly treated with amputation because of concerns of postoperative urethral stricture and occlusion. To the authors' knowledge, this case represented the first time that a successful end-to-end anastomosis of the distal portion of the urethra has been performed in a stallion.

Management of a urethral tear with porcine small intestinal submucosa-augmented urethroplasty and balloon dilation for subsequent urethral stricture in a cat.

CASE DESCRIPTION: As a result of vehicular trauma, a 3-year-old neutered male domestic shorthair cat sustained luxation of the sacrocaudal joint and a urethral tear. CLINICAL FINDINGS: Retrograde contrast urethrocystography revealed a urethral tear at the level of the ischiatic tuberosity. Conservative treatment for 7 days with a urethral catheter was unsuccessful. TREATMENT AND OUTCOME: An approach for a perineal urethrostomy was performed and revealed a large urethral tear (4 mm in length in a craniocaudal orientation and encompassing approx 50% of the urethral circumference) proximal to the bulbourethral glands. Urethroplasty was performed with a graft of a rectangular section of single-layer porcine small intestinal submucosa. Perineal urethrostomy was then completed routinely, and a urethral catheter was left in place for 5 days. Two days after removal of the urethral catheter, stranguria was noted. Retrograde contrast urethrocystography revealed a urethral stricture. Balloon dilation of the urethral stricture was performed, and the cat's stranguria improved. Ten weeks following balloon dilation, the cat developed hematuria, and a urinary tract infection and urethral stricture were diagnosed. Balloon dilation was repeated with instillation of triamcinolone solution at the stricture site. Eighteen months later (approx 21 months after the initial surgery), the cat was urinating normally. CLINICAL RELEVANCE: The outcome for the cat of this report indicated that porcine small intestinal submucosa may be used to successfully augment urethroplasty for treatment of traumatic urethral tears in cats. Urethral balloon dilation with triamcinolone instillation may be used to treat postoperative urethral strictures.

Partial urethral duplication in a cat.

CASE DESCRIPTION: A 3-year-old neutered male domestic shorthair cat with a history of urethral obstruction was evaluated at a veterinary referral center for acute onset of hunched posture and signs of discomfort on being handled. No evidence of urethral obstruction was found; signs initially responded to medical management, but the cat was presented to the primary care veterinarian < 48 hours after the initial examination with signs suggesting urethral obstruction. CLINICAL FINDINGS: No urinary calculi were detected radiographically. Attempted urinary catheter placement was unsuccessful, and the cat was returned to the referral center for evaluation and treatment of suspected urethral obstruction. Hematologic evaluation revealed hyperglobulinemia and leukocytosis; the cat was febrile, its prepuce was swollen, and its urinary bladder was soft but could not be manually expressed. TREATMENT AND OUTCOME: A urinary catheter was placed; urinalysis revealed hematuria, leukocyturia, and bacteriuria. Medical management included analgesic, antimicrobial, urethral antispasmodic, and IV fluid treatment. Positive-contrast cystourethrography results were equivocal for a congenital anomaly versus urethral rupture. Contrast-enhanced CT revealed a sinus communicating with the dorsal aspect of the urethra, and urethral rupture was ruled out. Partial urethral duplication was confirmed surgically; perineal urethrostomy was performed, creating an opening to the accessory urethra, and the strictured orthotopic urethra was ligated. Four weeks after surgery, the cat was doing well. CLINICAL RELEVANCE: This case highlighted the importance of advanced imaging to distinguish between urethral rupture and a congenital malformation in a cat with signs of lower urinary tract disease. This approach was pivotal to appropriate diagnosis and management and a favorable outcome for the patient.

Implantação de stent autoexpansível para tratamento de estenose uretral em cão: relato de caso / Implantation of self-expanding stent for treatment of urethral stenosis in dog - case report

O stent endovascular autoexpansível pode ser utilizado como forma de tratamento para estenose uretral em cães. O stent de nitinol é composto por uma liga de níquel e titânio que permite mudanças em suas estruturas sob a influência da temperatura corporal e tem excelente biocompatibilidade na uretra canina. Este estudo relata o caso de um cão, sem raça definida, 14 anos de idade, com histórico de disúria há duas semanas, diagnosticado com grande quantidade de cálculos e microcálculos na bexiga, no colo vesical e na uretra prostática, também cistite e hiperplasia prostática. Depois de tratamento para cistite, orquiectomia e cistotomia para retirada dos cálculos, porém sem melhora clínica após 30 dias de acompanhamento, com o paciente apresentando disúria, foi realizada uretrocistografia retrógrada, que evidenciou estenose da uretra prostática. Esse paciente foi encaminhado para procedimento de implantação de um stent de nitinol na uretra prostática. Imediatamente após o procedimento e até o presente momento, o paciente apresenta micção espontânea, sem qualquer sinal de disúria, sendo este o primeiro relato no Brasil do uso dessa técnica.(AU)

The endovascular stent is used for treatment of urethral stricture in dogs. The nitinol stent is composed by nickel and titanium alloy that allows changes in its structures under the influence of body temperature and has excellent biocompatibility in the canine urethra. This study aims to report a case of a 14 - year - old male dog without defined breed with dysuria for two weeks. Ultrasonographic evaluation revealed microcalculi and calculi in bladder, prostatic urethral obstruction and prostatic hyperplasia. Cystotomy was performed to remove uroliths, but after 30 days of hospitalization there was no clinical improvement. A double-contrast retrograde urethrocystography was performed and showed persistence of prostatic urethral obstruction. The pacient was submitted to a new surgery to place a self-expanding nitinol stent and presented spontaneous urination after the procedure. This is the first report of this technique in Brazil.(AU)

Submucosal Collagen Injection for Management of Urinary Incontinence Following Urethral Stent Placement.

An 8-year-old, entire, male British Bulldog was referred for a week-long history of severe stranguria and dysuria. A prostatic wash was diagnostic of prostatic carcinoma. A transluminal urethral stent was placed in the proximal urethra, which resulted in resolution of the urinary obstruction, however, the dog developed severe urinary incontinence after the procedure. Cystoscopically-guided submucosal collagen injections were performed immediately proximal to the os penis. The dog's incontinence resolved with a single collagen injection for the 10-month follow-up period.

Transposição e anastomose uretral pré-púbica em um cão macho com estenose extensa da uretra intrapélvica / Prepubic urethral transposition in a male dog with extensive stenosis of the pelvic urethra

We report the use of a new surgical technique in a male dog affected by extensive stenosis of intrapelvic urethra through a antepubic urethral deviation, as an alternative to prepubic urethrostomy and ablation of the external genitalia. The technique consisted initially of orchiectomy, followed by retroumbilical celiotomy, transverse section of the penis in the pre-scrotal region and transposition of this towards the abdominal cavity by making anastomosis to the prostatic urethra. The dog was evaluated clinically and by urethrography retrograde positive contrast for up to four years after the procedure without any clinical signs, changes in urine stream or stenosis image. It is concluded that the pre-pubic urethral transposition is a viable alternative treatment for this dog affected by extensive stenosis of the membranous urethra.(AU)

Use of poliglecaprone 25 for perineal urethrostomy in cats: 61 cases (2007-2013).

OBJECTIVE To determine frequency of postoperative complications in cats undergoing perineal urethrostomy (PU) in which poliglecaprone 25 was used for closure and identify possible predisposing factors for development of complications. DESIGN Retrospective case series. ANIMALS 61 cats that underwent PU. PROCEDURES Medical records for cats that underwent PU at Gulf Coast Veterinary Specialists between 2007 and 2012 were reviewed. Information regarding signalment, perioperative conditions, surgical procedures, treatments, and postoperative complications were obtained from medical records and by telephone follow-up. RESULTS 11 of 61 (18%) cats developed minor short-term (ie, ≤ 2 months after surgery) complications, 1 of 61 (1.6%) cats developed a major short-term complication requiring surgical revision, and 16 of 38 (42%) cats developed minor long-term complications. No major long-term complications were identified. Preoperative urinary tract infection was significantly associated with development of minor short-term complications, but use of an indwelling urinary catheter after surgery was not significantly associated with development of postoperative complications. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that poliglecaprone 25 may be an acceptable suture for apposition of mucosa to skin in cats undergoing PU. Short- and long-term complication rates and percentage of cats requiring revision surgery were comparable to values reported in previous studies in which slowly absorbable or nonabsorbable sutures were used.

Vesicopreputial anastomosis for the treatment of obstructive urolithiasis in goats.

OBJECTIVE: To describe a novel surgical technique for the correction of recurrent obstructive urolithiasis in male goats. STUDY DESIGN: Clinical case series. ANIMALS: Castrated male goats (n = 4). METHODS: Medical records of male goats having undergone vesicopreputial anastomosis (VPA) as a treatment for obstructive urolithiasis were reviewed for history, signalment, clinical signs, and intraoperative and postoperative complications. Long-term follow-up (≥12 months) was obtained by telephone interview with owners or by clinical examination. RESULTS: All goats had undergone at least one surgical procedure (median, 2.5, range 2-4) to correct obstructive urolithiasis before undergoing VPA. Postoperative complications included premature removal of the tube from the bladder (1 goat), bacterial cystitis (2), and abscess formation (1). One goat suffered stricture of the anastomosis site 3 months following the original procedure and underwent a second VPA and 1 goat died 7 months after surgery due to severe, acute hydronephrosis and renal failure. Long-term survival ≥12 months was good with 3/4 goats (75%) or 3/5 VPA procedures (60%) having unobstructed urine flow at 12 months. CONCLUSION: Vesicopreputial anastomosis is a feasible surgical procedure for the correction of recurrent obstructive urolithiasis in male goats and one that can result in a favorable clinical outcome. Further investigation in a larger population of goats is warranted for the evaluation of the suitability of VPA in male goats with obstructive urolithiasis.

Use of an Absorbable Urethral Stent for the Management of a Urethral Stricture in a Stallion.

OBJECTIVE: To describe the successful management of a urethral stricture with an absorbable stent in a stallion. STUDY DESIGN: Clinical report. ANIMALS: Stallion with a urethral stricture. RESULTS: A 12-year-old Thoroughbred breeding stallion was evaluated for acute onset of colic. Uroperitoneum because of presumptive urinary bladder rupture, with urethral obstruction by a urethrolith, was diagnosed. The uroperitoneum was treated conservatively. The urethrolith was removed through a perineal urethrotomy. Approximately 15 weeks after urethrolith removal, the stallion presented with a urethral stricture. The stricture was unsuccessfully treated with an indwelling urinary catheter and 4 attempts at balloon dilation. Eight weeks after diagnosis of stricture, an absorbable polydioxanone (20 mm × 80 mm) urethral stent was implanted under percutaneous, ultrasound guidance. Urethroscopy was performed at 70, 155, and 230 days after stent placement and the endoscope passed through the affected site without complication. Urethroscopy at 155 days showed the stent had been reabsorbed. Follow-up 20 months after stent placement reports the stallion was able to void a normal urine stream. CONCLUSIONS: Absorbable urethral stent placement was a feasible treatment for urethral stricture in this stallion.

Pollakiuria and stranguria in a Labrador retriever with penile HSA.

An approximately 8 yr old castrated male Labrador retriever presented for evaluation of weight loss, stranguria, and pollakiuria. Lysis of the proximal one-third of the os penis was diagnosed on abdominal radiographs, and a positive contrast urethrography revealed a smoothly marginated filling defect along the dorsal aspect of the urethra at the level of the radiographically observed osteolysis. Regional ultrasound revealed an echogenic mass at the proximal aspect of the os penis with a severely irregular and discontinuous periosteal surface. A penile hemangiosarcoma (HSA) was confirmed on histopathologic evaluation after a penile amputation and scrotal urethrostomy were performed. Although HSA is a common malignant neoplasm in dogs, lysis of the os penis has not previously been documented. Adjunctive chemotherapy, although recommended, was declined, and the patient survived 236 days postoperatively. That survival time is considerably longer than the average survival time for patients with HSA, other than cutaneous forms of HSA. Although an uncommon presentation, HSA of the penis should be considered a differential diagnosis in older canines with signs of lower urinary tract disease, especially in breeds that have been documented to be predisposed to HSA.

A retrospective analysis of urethral rupture in 63 cats.

The aim of this study was to investigate the short- and long-term morbidity and mortality associated with urethral rupture in cats. Medical records were reviewed from four veterinary hospitals. Diagnosis was made from retrograde urethrography or direct visualisation during surgery. Location of rupture was categorised as pre-, intra- or post-pelvic. Follow-up data were collected from referring veterinarians. Sixty-three cats were included in the study of which, males predominated (88.9%). Trauma was the most common cause (n = 35; 55.6%) with the remainder due to iatrogenic injury. Forty-eight cats (88.9%) were treated surgically and six (11.1%) managed conservatively. Significant differences between cats suffering traumatic versus iatrogenic injury included the presence of musculoskeletal injuries (P <0.001); the location of rupture (P <0.001); the degree of rupture (P <0.001); definitive management (P <0.001) and short-term complications (P = 0.026). Short-term complications were significantly associated with the following: musculoskeletal injuries (P = 0.012); uroabdomen/uroretroperitoneum (P = 0.004); azotaemia (P = 0.021); postoperative urinary diversion (P = 0.036) and >1 surgery performed (P = 0.006). Forty-seven cats (74.6%) survived to discharge. Prognostic factors associated with survival to discharge included the presence of musculoskeletal injuries (P = 0.017); cause of rupture (P = 0.017); location of rupture (P = 0.039) and definitive management (P = 0.020). Twenty-four cats (57.1%) suffered short-term complications and 10 (27.0%) suffered long-term complications. Of those cats surviving to discharge 30 (71.4%) had a good outcome. Median follow-up was 16 months. Outcome was significantly associated with cause of rupture (P = 0.04); short-term complications (P = 0.03) and long-term complications (P <0.001). In conclusion, a significantly greater proportion of cats with iatrogenic injuries survived to discharge and had a good outcome compared with those that suffered trauma.

Treatment of traumatic penile urethral stricture in a dog with a self-expanding, covered nitinol stent.

CASE DESCRIPTION: An 8-month-old castrated male mixed-breed dog was evaluated because of hematuria, stranguria, and dysuria of approximately 2 weeks' duration that developed immediately following elective castration. CLINICAL FINDINGS: Results of physical examination, ultrasonography, retrograde double-contrast cystourethrography, and urethroscopy were consistent with a traumatic urethral stricture immediately proximal to the os penis resulting in a partial obstruction of urine outflow. Results of ultrasonographic examination of abdominal organs were considered normal. Digital radiography revealed no evidence of calculi. TREATMENT AND OUTCOME: Balloon dilation of the urethral stricture was performed and was followed by 2 bougienage procedures during the subsequent 2 weeks when clinical signs returned. The owners declined scrotal urethrostomy, and a self-expanding, covered nitinol stent was placed approximately 3 weeks after the initial evaluation, resulting in amelioration of clinical signs. Results of follow-up urethroscopy and contrast cystourethrography 1 year after stent placement revealed a statically positioned, patent urethral stent, although a small number of polypoid mucosal structures were identified distal to the stent and 1 small structure consistent with tissue ingrowth into the stent was identified. CLINICAL RELEVANCE: Placement of a covered nitinol stent resulted in long-term resolution of clinical signs associated with traumatic stricture of the penile urethra in this young dog. Because the os penis in dogs limits radial expansion of the urethra, its presence may limit the use of stents in this location.

Modified proximal perineal urethrostomy technique for treatment of urethral stricture in goats.

OBJECTIVE: To report a modified procedure for perineal urethrostomy (PU) in goats. STUDY DESIGN: Case series. ANIMALS: Adult castrated male pet goats (n = 11) that had recurrence of urinary tract obstruction after one or more surgical procedures for obstructive urolithiasis. METHODS: Medical records (May 2008-February 2011) of goats that had a modified proximal PU were reviewed for history, signalment, and intraoperative and postoperative complications. Follow up was obtained through clinical examination or by telephone interview of owners or referring veterinarians. RESULTS: Ten goats survived to discharge. Postoperative complications included hemorrhage (n = 7), misdirected urine stream (3), obstructive urolithiasis (2), and bladder atony, dysuria, dehiscence, or delayed healing (1 each). One goat died acutely 15 hours after surgery from peritonitis, pleuritis, hemorrhagic cystitis, and hepatic lipidosis, and 1 goat was euthanatized 14 months after surgery because of renal failure and persistent cystitis. Urethrostomy sites were patent and functional in 9 goats available for long-term follow-up (>12 months). CONCLUSIONS: Transection of penile body attachments from the pelvis and careful mucocutaneous apposition may decrease the risk of postoperative urethral stricture formation in goats after PU. Hemorrhage is common after the procedure but does not affect clinical outcome.