Ultrasonographic and radiographic diagnosis of ectopic ureter in a dog

Background: Ureteral ectopia (or ectopic ureter) is a congenital anomaly of the urinary system in which the ureter insertsanywhere other than the vesical trigone. This anatomical change may have unilateral or bilateral involvement. The mostevident clinical sign, occurring mostly in females, is urinary incontinence, however in some cases the condition may progressto nephritis and dilation of the renal pelvis. The diagnosis is established through imaging, and definitive treatment requiressurgical approach. The present study reports a case of ureteral ectopia in a dog which was diagnosed by ultrasound andcontrast radiography (excretory urography) and successfully treated by neoureterostomy.Case: A 10-month-old female American Pit Bull Terrier was attended at the Veterinary Hospital of the Federal Rural University of the Semi-Arid (UFERSA), in Mossoró, RN. Her owner reported incontinence of dark, malodorous urine sincebirth as the chief complaint. After clinical examination, cystitis was suspected, and a complete blood count, urinalysis,and abdominal ultrasound was requested. The blood count and creatinine were within the reference values. The presenceof struvite crystals were found on urinalysis. Ultrasound examination revealed a tortuous, dilated right ureter from therenal pelvis to the urinary bladder; no uroliths were identified as a cause of potential obstruction, but the ipsilateral kidneyshowed increased cortical echogenicity, loss of corticomedullary definition, and moderate pelvic dilation. These findingssupported a presumptive diagnosis of ectopic ureter. For the purpose of confirming this suspicion, excretory urography wasperformed, revealing unilateral ureteral dilation and radiopaque contrast uptake following the path of the urethra. Once thediagnosis was confirmed, surgery was performed to correct the ureteral ectopia using the standard...(AU)

Ultrasonographic and radiographic diagnosis of ectopic ureter in a dog

Background: Ureteral ectopia (or ectopic ureter) is a congenital anomaly of the urinary system in which the ureter insertsanywhere other than the vesical trigone. This anatomical change may have unilateral or bilateral involvement. The mostevident clinical sign, occurring mostly in females, is urinary incontinence, however in some cases the condition may progressto nephritis and dilation of the renal pelvis. The diagnosis is established through imaging, and definitive treatment requiressurgical approach. The present study reports a case of ureteral ectopia in a dog which was diagnosed by ultrasound andcontrast radiography (excretory urography) and successfully treated by neoureterostomy.Case: A 10-month-old female American Pit Bull Terrier was attended at the Veterinary Hospital of the Federal Rural University of the Semi-Arid (UFERSA), in Mossoró, RN. Her owner reported incontinence of dark, malodorous urine sincebirth as the chief complaint. After clinical examination, cystitis was suspected, and a complete blood count, urinalysis,and abdominal ultrasound was requested. The blood count and creatinine were within the reference values. The presenceof struvite crystals were found on urinalysis. Ultrasound examination revealed a tortuous, dilated right ureter from therenal pelvis to the urinary bladder; no uroliths were identified as a cause of potential obstruction, but the ipsilateral kidneyshowed increased cortical echogenicity, loss of corticomedullary definition, and moderate pelvic dilation. These findingssupported a presumptive diagnosis of ectopic ureter. For the purpose of confirming this suspicion, excretory urography wasperformed, revealing unilateral ureteral dilation and radiopaque contrast uptake following the path of the urethra. Once thediagnosis was confirmed, surgery was performed to correct the ureteral ectopia using the standard...

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)

Radical Cystectomy and Cutaneous Ureterostomy in 4 Dogs with Trigonal Transitional Cell Carcinoma: Description of Technique and Case Series.

OBJECTIVE: To describe radical cystectomy followed by cutaneous ureterostomy as a treatment of invasive bladder neoplasia in dogs. STUDY DESIGN: Retrospective study. ANIMALS: Client-owned dogs with transitional cell carcinoma of the bladder trigone (n=4). METHODS: Perioperative complications and long-term outcomes of dogs that underwent cutaneous ureterostomy following radical cystectomy and lymphadenectomy for transitional cell carcinoma of the urinary bladder trigone were reviewed. Both ureters were transected and anastomosed to the ventral abdominal skin. Polyvinyl chloride catheters were placed in the ureteral stomas and maintained for 5 days. After catheter removal, dogs were managed with an absorbent diaper over the stomas. Long-term outcome and survival were documented by follow-up visits or phone contact. RESULTS: Median age at the time of surgery was 10.3 years (range, 8-12). Average procedural time was ∼4.7 hours (range, 3.8-6.1). Minor complications occurred in all dogs, including bleeding and edema of the ureterostomy site during the first 2-3 days after surgery. One dog developed urine scald that resolved with improved stoma care and hygiene. Median survival time after surgery was 278.6 days (range, 47-498). Distant metastases were documented in 2 dogs at 47 days (bone) and 369 days (lung) after surgery. CONCLUSION: Radical cystectomy with cutaneous ureterostomy is a viable salvage procedure for urinary diversion after cystectomy in dogs with invasive bladder neoplasia. Postoperative management and quality of life were considered acceptable by most owners. Future studies are warranted to evaluate survival time in a larger number of animals.