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1.
OBJECTIVE: To describe and evaluate the outcome of cystoscopic-guided laser ablation of intramural ureteral ectopia in male dogs. DESIGN: Retrospective case series. ANIMALS: 4 incontinent male dogs with intramural ureteral ectopia. PROCEDURES: Intramural ectopic ureters were diagnosed via preoperative computed tomography-IV urography and subsequent cystoscopy. Transurethral cystoscopic-guided laser ablation (diode laser [n = 3 dogs] and holmium:yttrium aluminum garnet laser [1]) was performed to proximally relocate the ectopic ureteral orifice to the urinary bladder. Fluoroscopy was used during the procedures to confirm that the ureteral tract was intramural and the ureteral orifice was intravesicular after the procedure. In 1 dog with bilateral ureteral ectopia, staged laser ablation was performed at 6-week intervals because of difficulty viewing the second ureter on the first attempt. All ureteral orifices were initially located in the middle to proximal portion of the prostatic portion of the urethra. Six weeks after surgery, imaging was repeated in 3 of 4 dogs. RESULTS: Postoperative dysuria or hematuria did not develop. All dogs were immediately continent after laser treatment and remained so at a median follow-up period of 18 months (range, 15 to 20 months) without medical management. Conclusions and CLINICAL RELEVANCE: Ureteral ectopia can cause urinary incontinence in male dogs and is usually associated with other urinary tract abnormalities. Cystoscopic-guided laser ablation provided an effective and minimally invasive alternative to surgical management of intramural ureteral ectopia.  相似文献   

2.
OBJECTIVE: To evaluate transurethral cystoscopy and excretory urography for diagnosis of ectopic ureter in female dogs and identify concurrent urogenital abnormalities. DESIGN: Retrospective study. ANIMALS: 25 female dogs. PROCEDURE: Medical records of female dogs that underwent transurethral cystoscopy, excretory urography, and ventral cystotomy were reviewed for signalment, history, physical examination findings, results of bacteriologic culture of urine, and surgical findings. Videotapes of transurethral cystoscopy and radiographic studies were reviewed systematically without knowledge of surgical findings. RESULTS: Ectopic ureters were diagnosed in 24 of 25 (96%) of the dogs, bilaterally in 22 of 24 (91.6%) dogs. Cystoscopic evaluation yielded a correct diagnosis in all dogs when results of ventral cystotomy were used as the diagnostic standard. Cystoscopic evaluation identified a terminal ureteral opening for all ureters. Urethral fenestrations, troughs, striping, and tenting were identified. Abnormalities of the vestibule were identified in all examinations available for review (24/25). The paramesonephric septal remnant and its association with ectopic ureters were identified and characterized by cystoscopy. Radiographic findings were discordant with surgical findings and correctly identified 36 of 46 (78.2%) ectopic ureters and 2 of 4 normal ureters. Hydroureter and renal abnormalities were associated with distal urethral ectopic ureters on radiographic evaluations. CONCLUSIONS AND CLINICAL RELEVANCE: Transurethral cystoscopy was accurate and minimally invasive for identification and classification of ectopic ureters in dogs. Contrast radiography had limitations in diagnosis of ectopic ureters. Cystoscopic findings and associated vaginal and vestibular abnormalities support abnormal embryologic development in the pathogenesis of ectopic ureters.  相似文献   

3.
A 1-year-old neutered male mixed-breed dog was evaluated because of signs of urinary incontinence. Retrograde positive contrast urethrocystography and excretory urography with pneumocystography revealed bilateral intramural ectopic ureters and absence of the right kidney. During abdominal exploratory surgery, only the left kidney was located. The left intramural ectopic ureter was repaired by neoureterostomy (creation of a new opening for the ureter to enable urine to empty into the bladder). The right ectopic ureter was ligated at its entrance into the urinary bladder serosa. Results of excretory urography (performed immediately after surgery and repeated 8 weeks later) revealed successful correction of the left intramural ectopic ureter. Twelve weeks after surgery, the dog remained continent. To the authors' knowledge, there are few reports of ectopic ureters in male dogs; furthermore, the urinary tract abnormalities detected concurrently in this dog are also unusual.  相似文献   

4.
Severe hydronephrosis and hydroureter associated with ectopic ureters were diagnosed in 2 dogs. Surgical transplantation of the ectopic ureters into the urinary bladder resulted in urinary continence in both dogs. Intravenous urography revealed a marked decrease in the size of hydronephrosis and hydroureter in both dogs 28 to 35 weeks after surgery. In 1 dog with bilateral ureteral ectopia, kidney size and renal function remained normal for 5 years after surgery. A dog with one ectopic ureter and an associated ureterocele had a marked reduction in size of the affected kidney and an apparent decrease in function of that kidney, as indicated by decreased opacification on an intravenous urogram.  相似文献   

5.
No single technique allows one to diagnose all causes of urinary incontinence and abnormal increased frequency of urination. Cystography is indicated for cases of abnormal urinary bladder position, size, or shape. Ultrasonography is best for mass effects, calculi, and extrinsic nonskeletal abnormalities. The combined cystography and excretory urography technique is recommended for diagnosing ectopic ureteral insertions. Computerized tomography and MR imaging are indicated when the techniques described previously fail to elucidate the problem sufficiently, but these methods are usually not selected as primary diagnostic techniques.  相似文献   

6.
A male cat with persistent urinary incontinence is described. Definitive diagnosis of unilateral ectopic ureter was obtained by intravenous urography, after which surgical re-implantation of the ureter into the bladder was performed. The literature on ureteral ectopia in cats is discussed.  相似文献   

7.
A male cat with persistent urinary incontinence is described. Definitive diagnosis of unilateral ectopic ureter was obtained by intravenous urography, after which surgical re-implantation of the ureter into the bladder was performed. The literature on ureteral ectopia in cats is discussed.  相似文献   

8.
Computed tomographic maximum intensity projection (MIP) images have been shown to improve reader confidence in their diagnoses and to improve detection of vascular structures and pulmonary nodules. The objectives of this method comparison study were to compare transverse source computed tomographic excretory urography (CTEU) images to two, five, and 10 slab thick MIP images for diagnosing canine ectopic ureters, compare reader confidence, and evaluate interobserver agreement. Two board‐certified veterinary radiologists and a board‐certified small animal internist blindly reviewed transverse source CTEU and two, five, and 10 slab thick MIP images of 24 dogs enrolled in the study. Inclusion criteria included a diagnostic CTEU and either cystoscopic or surgical confirmation of the presence or absence of ureteral ectopia. Eleven dogs were confirmed to have 17 ectopic ureters at surgery and/or cystoscopically. There was no significant difference in reader diagnoses between viewing methods or between viewing methods and the surgical/cystoscopic findings (P < 0.001). Reader confidence was significantly greater on two (P = 0.0080) and five (P = 0.0009) slab thick MIP images with significant interobserver agreement between readers for all viewing methods (P values ranging between 0.0363 and <0.001). In addition, the diagnostic accuracy of MIP images was similar to or better than transverse source CTEU images, when assessed by a radiologist. The study results suggest that CTEU is a reliable imaging technique for diagnosing canine ectopic ureters among specialists of varied experience. In addition, thin slice reconstructed MIP images improve reader confidence and potentially diagnostic accuracy, and thus their use should be considered, especially in more challenging cases.  相似文献   

9.
A 7-week-old Appaloosa filly was admitted for persistent urinary incontinence since birth. Vaginal speculum examination revealed urine flowing from an opening in the right vaginal wall. Cystoscopy demonstrated that the ureters did not terminate at the bladder. The endoscope passed easily from the vagina directly into a dilated right ureter. An excretory urogram confirmed the vaginal termination of at least one ureter, based upon extensive filling of the vagina with contrast media in the absence of bladder filling. Bilateral hydroureter and dilated renal pelves were demonstrated both by excretory urography and by ultrasonography. Euthanasia was requested by the owner in lieu of attempted surgical correction. At necropsy, it was confirmed that the right ureter entered the vagina and the left ureter terminated at the urethra. The diagnosis of bilateral ectopic ureter in this foal was suggested by the history and clinical signs, supported by endoscopy and ultrasonography, and confirmed by excretory urography and necropsy. This case establishes the value of diagnostic imaging techniques in the antemortem diagnosis of ectopic ureter.  相似文献   

10.
A male dog and cat were evaluated because of clinical signs associated with hydronephrosis. Both animals had ectopic ureters, but neither had urinary incontinence. The diagnoses were made by use of ultrasonography, excretory urography, retrograde urethrocystography, and surgery. In both animals, hydronephrosis was bilateral but of unequal severity, such that unilateral ureteronephrectomy could be performed. Both animals underwent ureteroneocystostomy of the remaining ureter. This treatment resulted in good clinical outcome during follow-up periods of 18 months and 3 years.  相似文献   

11.
This work reports the use of laparoscopic-transducer sonography for the examination of the urinary system in a swine model. Animals underwent a two-phase study. In the first phase, the urinary system was examined using laparoscopic sonography. In the second a partial ureteral obstruction was induced, and sonographic changes were recorded and evaluated. Sonography was used to evaluate kidneys, ureters, and bladder. Anatomic structures were evaluated and the following pathological findings were identified: renal cysts, one polycystic kidney, dilation of the renal pelvis, hydronephrosis, and one perirenal pseudocyst. Where necessary, contrast digital fluoroscopy (excretory urography and retrograde ureteropyelography) was also performed. Laparoscopic sonography mainly is used for evaluation prior to laparoscopic surgery to guide decisions relating to surgery. The quality of the images obtained laparoscopically is superior to that of percutaneous or transabdominal images, because artifacts are reduced and the contact surface of the transducer is placed directly over the study area. Laparoscopic sonography proved highly effective for studying renal and ureteral disorders prior to minimally invasive surgery.  相似文献   

12.
A one‐year‐old intact male German shepherd dog was referred with a 3‐month history of dysuria and pollakiuria. Physical examination revealed a large firm mass in the caudal abdomen. Findings from survey radiography, negative contrast cystography, computed tomographic (CT) retrograde positive contrast cystography, and CT excretory urography were consistent with a large urinary bladder diverticulum. An exploratory laparotomy revealed a normal wall appearance in the ventral compartment (true bladder) and marked thinning of the wall in the dorsal compartment (diverticulum). Both ureters inserted into the ventral compartment. The dorsal compartment was excised and histopathology confirmed the diagnosis of urinary bladder diverticulum.  相似文献   

13.
A 5‐year‐old neutered male Akita had a 5‐month history of hematuria. Bilateral orthotopic ureteroceles were diagnosed using a combination of sonography, computed tomography (CT), and radiography. With CT excretory urography, the ureteroceles appeared as two intraluminal cystic structures in the vesicoureteral region of the urinary bladder, which directly communicated with dilated ureters. Unlike the other imaging modalities CT excretory urography provided a definitive diagnosis by confirming the communication between the hydroureters and the cystic dilations in the caudodorsal aspect of the urinary bladder.  相似文献   

14.
Linda J.  Konde  DVM  Robert H.  Wrigley  BVSc  MS  DVR  MRCVS  Richard D.  Park  DVM  PhD  Jack L.  Lebel  DVM  PhD 《Veterinary radiology & ultrasound》1985,26(3):74-81
Eight dogs with renal neoplasia were radiographically and sonographically examined. An enlarged, nonopacified kidney was seen on the excretory urogram in four dogs, but differentiation between a solid mass or severe hydronephrosis was not possible. The excretory urogram suggested an avascular lesion in one kidney, but differentiation between solid or cystic disease was not possible. Renal neoplasia was diagnosed in two dogs by excretory urography. Radiographic examination suggested splenic neoplasia in one dog. Solid masses were sonographically diagnosed in all dogs. A metastatic lesion was sonographically diagnosed in the opposite kidney of one dog that was missed on the radiographic examination. Ultrasonography com-plemented radiography as a diagnostic modality in eliciting additional information on renal disease. Sonograms did not allow determination of tumor cell type or whether the tumor was benign or malignant.  相似文献   

15.
Ureteral ectopia is a congenital abnormality of the terminal segment of one or both ureters in which the ureteral orifice is located distal to the trigone of the bladder. Continuous or intermittent urinary incontinence is the most frequently reported clinical symptom associated with ureteral ectopia. A variety of anatomic morphologies of ectopic ureters have been reported. Historically, surgical therapy focused on reestablishing drainage of the ureters into the bladder lumen. However, continued urinary incontinence after surgery is the most frequently reported complication. Specific classification and successful management of the various types of ectopic ureters remain diagnostic and therapeutic challenges to the veterinary clinician. Cystoscopic evaluation of the lower urinary tract and urodynamic evaluation of bladder and urethral function has improved the presurgical assessment of the patient. Surgical procedures, which are aimed at repositioning the ureteral orifice(s) within the bladder lumen and treating primary sphincter incompetence, are necessary to successfully manage small animal patients with ectopic ureters.  相似文献   

16.
The two leading causes of urinary incontinence in dogs are ureteral ectopia in juveniles and urethral sphincter mechanism incompetence in adults. While the accuracy of diagnosis of ectopic ureters has improved due to increased use of CT and/or cystoscopy, the diagnosis of urethral sphincter mechanism incompetence largely remains one of exclusion. New treatment options have been developed for both conditions, which have reduced morbidity and mortality, although the rate of long‐term urinary continence has not significantly improved for either and neither has our understanding of the pathophysiology behind these failures. This review provides updates on the management of both of these conditions, with discussion of controversial areas and thoughts for future directions.  相似文献   

17.
A 2-year-old Himalayan cat was examined because of 4 days of vomiting, lethargy; and anorexia. The cat had undergone hysterectomy and removal of left ovarian remnants 5 days earlier. Results of laboratory testing and excretory urography were consistent with uremia and bilateral ureteral obstruction. Nephrostomy catheters were placed to drain urine and allow time for physiologic diuresis prior to definitive repair. During the next 2 days, the cat's physiologic status improved greatly. The cat underwent exploratory surgery, and both ureters were found to be ligated. The healthy proximal portions of the ureters were implanted into the bladder. Six months after surgery, the cat was doing well, and excretory urography demonstrated that both ureters were patent. Bilateral obstruction of the ureters is a life-threatening condition that can be difficult to correct in cats. Placement of nephrostomy catheters allows time for improvement in the cat's physiologic status prior to the protracted anesthesia time needed for surgical repair of the ureters.  相似文献   

18.
OBJECTIVES: To report the diagnosis and outcome after surgical correction of bilateral distal ureteral anomalies in a Standardbred filly. STUDY DESIGN: Clinical case report. ANIMAL: An 8-month-old, 310 kg Standardbred filly with left ureteral atresia and right ureteral ectopia. METHODS: The filly was admitted for evaluation of incontinence since birth and severe urine scalding of the hindquarters. Diagnosis was made by both direct (cystoscopy and vaginoscopy) and indirect (intravenous pyelography, ultrasonography, and scintigraphy) evaluation of the ureters and bladder. The filly had left ureteral atresia, hydronephrosis, and decreased left-sided renal function and right ureteral ectopia before surgery. Surgical correction was performed on the left by an end-to-side stapled anastomosis technique and on the right by a side-to-side hand-sewn anastomosis technique. RESULTS: Surgical correction was successful. The filly had no postoperative complications and remained continent 18 months after surgery. Left renal function improved. CONCLUSION: Ureteral anomalies can be successfully repaired in larger (>300 kg) foals and some renal function may be restored after surgical correction. CLINICAL RELEVANCE: Scintigraphy should be considered in diagnosis of ureteral anomalies, assessing renal function, and determining prognosis for horses with hydronephrosis caused by ureteral ectopia and atresia.  相似文献   

19.
An ectopic ureter extending to the urinary bladder and to the proximal portion of the urethra was diagnosed in a 6-month-old dog with urinary incontinence. The diagnosis was made by use of excretory urography. The kidney and ureter were removed. When urinary incontinence continued, positive-contrast cystography was performed. The ectopic ureter was found to bypass the bladder via a submucosal extension that emptied into the urethra.  相似文献   

20.
A 10-year-old spayed female dalmatian dog developed acute vomiting and abdominal pain. Ultrasound examination of the abdomen showed right hydronephrosis and proximal ureter dilation with mild retroperitoneal free fluid. Computed tomography (CT) of the abdomen confirmed the ultrasonographic findings and revealed, additionally, a right ureteral stone. Spontaneus rupture of the right ureter was confirmed with CT post ultrasound-guided percutaneous antegrade pyelography. Pyeloureteral rupture and the presence of a ureteral stone were confirmed at surgery.  相似文献   

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