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1.
A technique was developed for subtotal prostatectomy in dogs with the neodymium:yttrium-aluminum-garnet (Nd:YAG) laser. In six normal dogs, full-thickness necrosis of the prostate occurred if the central-lateral region within 5 mm of the urethra was photoablated at 60 watts for 1 second. Moderate to superficial necrosis occurred when the prostate within 5 mm of the urethra was photoablated at 35 watts for 2 seconds or 60 watts for 0.5 second. At necropsy, leakage of the urethra occurred in two dogs at sites treated at 60 watts for 1 second. In a clinical study, complications associated with subtotal prostatectomy with the Nd:YAG laser (n = 6) were compared with complications associated with prostatic drainage (n = 6) in dogs with prostatic disease. Intraoperative death (2/6 dogs) and nocturnal incontinence (4/4 surviving dogs) occurred with subtotal prostatectomy. Uncontrolled prostatic infection (2/6 dogs) occurred with prostatic drainage and resulted in the death of one dog on day 11. Four of five dogs surviving prostatic drainage developed recurrent urinary tract infection.  相似文献   

2.
Subtotal intracapsular prostatectomy was performed on five normal dogs. All dogs were maintained for 60 days postoperatively. No urinary abnormalities were noted following surgery with the exception of transient urinary incontinence in one dog that lasted for 7 days. Upon termination of the study, the prostatic urethra had reepithelized in all dogs where a dorsal strip of epithelium was left in place during surgery.  相似文献   

3.
Urinary Incontinence after Prostatectomy in Dogs   总被引：1，自引：0，他引：1  
Eleven dogs with prostatic disease were treated by total prostatectomy. Urinary incontinence persisted in three of nine dogs, two of which were also incontinent before surgery. The incidence of postoperative incontinence may be reduced by undermining the prostatic capsule to preserve as much prostatic urethra as possible. The risk of postoperative incontinence appeared greater if there was prostatic neoplasia or preoperative urinary incontinence.  相似文献   

4.
OBJECTIVES: Palliative surgery for advanced-stage prostatic cancers was tested with regard to survival rate and complications in a prospective randomised clinical study of dogs. Currently, therapeutic approaches have a grave long-term prognosis in clinically significant prostatic cancer. METHODS: Of 167 dogs with prostatic disorders, 24 were diagnosed with prostatic cancer. Eleven dogs underwent subtotal intracapsular prostatectomy, while in 10 dogs total prostatectomy was performed. The remaining three dogs were euthanased at their owner's request. Dogs treated by subtotal intracapsular prostatectomy and those treated by total prostatectomy were followed until their death. RESULTS: It was found that dogs treated by subtotal intracapsular prostatectomy survived 5.63 times longer (mean [sd] 112.0 [63.03] days) than those treated by total prostatectomy (19.9 [10.67] days) (P<0.01). Moreover, a significant decrease in postoperative complications after subtotal intracapsular prostatectomy was recorded, especially with regard to urinary incontinence. CLINICAL SIGNIFICANCE: It was concluded that, in the authors' facility, treatment of prostatic cancer by subtotal intracapsular prostatectomy was superior to that by total prostatectomy, with respect to both postoperative survival and serious complications.  相似文献   

5.
Introduction:  Complete prostatectomy with healing and normal urinary function is reported for some prostatic diseases. However incontinence rates of up to 100% for neoplasia‐affected dogs have dampened surgeons' enthusiasm for performing prostatectomies. Hypothesizing that incontinence following prostatectomy for prostatic cancer is related to extensive dissection associated with advanced invasion, it is proposed that there exists a subset of dogs with prostatic cancer that require minimal dissection and have the potential for quality survival for pet and owner.
Materials and Methods:  Dogs that received prostatectomy for neoplasia were qualitatively reviewed for commonalities associated with an outcome viewed as successful by owner and veterinarian.
Results:  Early diagnosis (prostatomegaly‐castrated population, high index of suspicion, ultrasound guided cytology) with referral center staging (ultrasound, contrast CT) enabled selection of appropriate surgery (urinary drainage, stent, prostatic enucleation, extrapelvic urethral anastomosis, cystoprostatourethrectomy with ureterocolonic anastomosis) for several dogs.
Conclusions:  A massive demographic shift toward castrated dogs and widespread availability of abdominal u/s can distinguish dogs that may benefit from advanced staging technology and treatment for locally confined prostatic neoplasia.
Application:  Step one is local control. Though based on a dribble of cases, it is clear that some dogs with prostatic cancer can be cured and live high quality lives. We wanted to leak these results so that oncologists will encourage early aggressive investigation and referral for prostatomegaly in castrated dogs.  相似文献   

6.
CASE DESCRIPTION: 8 dogs that underwent carbon dioxide (CO2) laser ablation of transitional cell carcinoma in the bladder trigone and proximal portion of the urethra and were also treated with mitotranxone and piroxicam. CLINICAL FINDINGS: Transitional cell carcinoma of the bladder frequently involves the trigone and urethra and can be difficult to manage surgically. Dogs underwent laser ablation of the primary tumor and were treated with mitoxantrone at a dosage of 5 mg/m2)every 3 weeks for 4 treatments. Piroxicam was given at a dosage of 0.3 mg/kg (0.14 mg/lb) once daily for the remaining life of the dog. TREATMENT AND OUTCOME: Median and mean disease-free intervals were 200 and 280 days, respectively. Median and mean survival times were 299 and 411 days, respectively. Adverse treatment effects were observed in 2 dogs; signs included mild, self-limiting inappetance and lethargy. The procedure appeared to be well tolerated; all treated dogs had rapid resolution of clinical signs of disease of the lower portion of the urinary tract. CLINICAL RELEVANCE: Although survival times achieved with CO2 laser ablation and treatment with mitoxantrone and piroxicam were similar to survival times associated with chemotherapy alone, resolution of clinical signs was better with the combined treatment.  相似文献   

7.
Reconstruction of the proximal urethra using a distally based tube flap mobilized from the ventral bladder wall was performed on 12 clinically normal dogs after total prostatectomy and resection of 2 cm of membranous urethra. One dog was euthanized at 6 hours and one at 36 hours after surgery because of surgical complications. Five dogs were euthanized at 10 days, two dogs at 6 weeks and three dogs at 12 weeks. Advancement of the tube flap allowed for tension-free anastomosis to the membranous urethra. Vascular integrity was maintained in all flaps. Intermittent to continuous postoperative urinary incontinence occurred in 7 of 10 dogs. The incontinence was transient in all 6 and 12 week dogs except one in which a persistent stress incontinence developed. Mild to severe dysuria was noted in 8 of 10 dogs, but was also transient in all of the 6 and 12 week dogs, with the exception of one dog. Postoperative urethral closure pressure profilometry revealed decreased tone in the membranous urethra in all 6 and 12 week dogs. It was concluded that proximal urethral reconstruction, using a ventral bladder tube flap, is a viable technique that may permit functional urodynamic recovery in dogs with significant proximal urethral loss.  相似文献   

8.
Objective- The purpose of this study was to determine the results of a new technique for management of prostatic retention cysts in dogs.
Study Design- A retrospective clinical study.
Animals- Eighteen client-owned dogs.
Methods- Dogs with prostatic retention cysts were treated by celiotomy and drainage of the cysts. The majority of the cyst wall was resected and residual cyst cavities were packed with omentum. All dogs were castrated.
Results- Long-term resolution of clinical signs was achieved in all dogs, with follow-up periods ranging from 6 to 42 months. Five dogs developed urinary incontinence postoperatively. This persisted in two dogs, but was well controlled with phenylpropanolamine. In the remaining dogs, the incontinence was transient and resolved within 2 months of surgery.
Conclusions- Partial cyst resection combined with omentalization and castration was a simple and effective means of managing prostatic retention cysts. The incidence of serious complications, including postoperative urinary incontinence, was low.  相似文献   

9.
Objective— To describe a surgical technique for resection of the entire bladder neck, including the trigone and proximal urethra in dogs with invasive tumors causing life-threatening urinary tract obstruction.
Study Design— Clinical case reports.
Animals— Dogs (n=2) with bladder tumors.
Methods— Circumferential excision of the bladder neck and proximal urethra with preservation of the neurovascular pedicles was performed to remove a rhabdomyosarcoma (dog 1) and a transitional cell carcinoma (dog 2) involving the trigone and bladder neck that were causing urinary tract obstruction. Reconstruction of the bladder and proximal urethra included bilateral ureteroneocystostomy. Adjuvant chemotherapy was administered postoperatively to both dogs.
Results— Postoperatively, dogs 1 and 2 were continent after 7 and 17 days, respectively, and regained normal urinary function after resolution of a transient pollakiuria. Dog 1 had no evidence of local or regional recurrence; however, a large solitary pulmonary metastatic lesion was diagnosed 8 months later. The dog was euthanatized despite a lack of clinical signs. Dog 2 had at least 1 metastatic lesion in the abdominal wall 6 months later and was euthanatized at 580 days because of renal failure.
Conclusion— En-bloc removal of the bladder neck and proximal urethra with preservation of the dorsal vascular and nervous pedicles, although a technically challenging procedure, can be performed without associated urinary incontinence or bladder wall necrosis.
Clinical Relevance— In dogs with invasive bladder tumors causing life-threatening urinary tract obstruction, resection of the bladder neck and proximal urethra should be considered as a promising surgical alternative to urinary diversion.  相似文献   

10.
Data from 48 dogs with nasal carcinomas treated with palliative radiation therapy (PRT) were retrospectively reviewed. Factors potentially influencing resolution of clinical signs and survival after PRT were evaluated. Clinical signs completely resolved in 66% of dogs for a median of 120 days. The overall median survival time was 146 days. Duration of response to PRT was shorter in dogs that had clinical signs for <90 days before PRT. Survival times were shorter in dogs that had partial or no resolution of clinical signs after PRT than in dogs that had complete resolution of clinical signs.  相似文献   

11.
Prostatectomy in dogs with clinical prostatic disease has been associated with a high incidence of urinary incontinence. In this study, urodynamic alterations after prostatectomy in 10 dogs without clinical prostatic disease were evaluated. Measurements of residual urine volume, simultaneous urethral pressure profilometry and electromyography, and carbon dioxide cystometry were made before and 14 and 20 weeks after prostatectomy. Voiding was observed daily for 20 weeks after prostatectomy. All dogs remained continent for 20 weeks after prostatectomy, and only minor urodynamic abnormalities were noted. Castration had no effect on urodynamic changes associated with prostatectomy. Prostatectomy produced minimal functional changes in dogs without clinical prostatic disease.  相似文献   

12.
Six client-owned dogs with prostate carcinoma were treated with a combination of (1) partial subcapsular prostatectomy using an Nd:YAG laser, (2) intraoperative photodynamic therapy using a halogen broad band lamp after local administration of a photosensitiser, and (3) systemic treatment with meloxicam. Median survival time was 41days (range 10-68days), which compared negatively with previous reports of subtotal laser prostatectomy combined with topical interleukin-2 administration, and photodynamic therapy alone. Despite treatment, the disease progressed locally, causing signs of stranguria to recur, and in the form of distant metastases. The recurrence of clinical signs due to the primary tumour despite photodynamic therapy is probably largely explained by insufficient penetration of light into the tissue. Better results may be obtained using other light sources (e.g. laser) and alternative techniques of light delivery, such as fibres or catheters allowing interstitial diffusion of light.  相似文献   

13.
A comparative study was conducted in ten dogs with signs of prostatic disease in order to evaluate the usefulness of the prepubic and transrectal ultrasonography for the examination of the prostate gland and for prostate biopsy guidance. Both techniques were adequate to identify the prostate gland and prostatic urethra. Transrectal ultrasound found 5 occurrencies of parenchymal echogenicity changes whereas the prepubic technique found only 2. Lesions in the cranial prostatic margin (two dogs) were detected only by prepubic ultrasound. Lesions of the caudal prostatic margin (six dogs), prostatic urethra disruption (two dogs) and prostatic capsule abnormalities (five dogs) were only recognized by the transrectal approach. Prepubic ultrasonography was useful for biopsy guidance of cranial prostatic lesions and transrectal ultrasonography was a good means for biopsy guidance of caudal lesions.  相似文献   

14.
Vaginourethroplasty for Treatment of Urethral Obstruction in the Bitch   总被引：1，自引：0，他引：1  
Vaginourethroplasty was performed in six bitches with infiltrative, obstructive urethral disease. The initial clinical signs included dysuria, hematuria, pollakiuria, and stranguria. Diagnosis was based on the clinical signs, plain radiography and contrast vagino-urethrogram examination, and urethral biopsy. Five dogs were diagnosed as having urethral neoplasia; the sixth dog had granulomatous urethritis. In all six dogs, up to 50% of the urethra and the urethral tubercle were resected to ensure adequate surgical margins. One dog was euthanatized 4 months after surgery for recurrence of a transitional cell carcinoma at the surgical site. Long-term resolution of the problem (minimum of 12 months) was achieved in the other five dogs. The frequency of serious complications, including urinary incontinence and ascending lower urinary tract infections, was low.  相似文献   

15.
Twenty dogs with abscessation of the prostate gland were treated by celiotomy, drainage, and digital exploration of the gland through bilateral capsulectomy wounds. Omentum was introduced through the capsulectomy wounds and packed into the abscess cavities around the prostatic urethra. Most dogs were discharged from the hospital within 48 hours of the surgery. Long-term resolution of the problem (no recurrence within 12 months) was achieved in 19 dogs. One dog had recurrent abscessation that was managed by the placement of dependant Penrose drains. Temporary tube cystostomy was performed postoperatively in one dog for the management of transient dysuria. One dog with septic peritonitis resulting from preoperative abscess rupture was managed by concurrent open peritoneal drainage. Intracapsular prostatic omentalization was a simple and effective means of managing prostatic abscessation with minimal requirement for postoperative hospitalization of the patient. The frequency of serious complications, including postoperative urinary incontinence, was low.  相似文献   

16.
Seven dogs with fecal incontinence and abnormal gaits were evaluated. Fecal incontinence was characterized as defecation of normal stools without posturing. Duration of clinical signs prior to evaluation ranged from 5 months to 3 years. Five dogs had upper motor neuron (UMN) paraparesis, and 2 dogs had UMN tetraparesis. With magnetic resonance imaging, spinal cord abnormalities primarily involving the dorsal aspect of the spinal cord were identified in all dogs. Five dogs had focal abnormalities, and 2 dogs had diffuse abnormalities of the spinal cord. Of the dogs with focal spinal cord lesions, 4 had cystic spinal cord abnormalities and 1 had a meningioma. Surgery was performed on all dogs with focal lesions; 4 of the 5 dogs had resolution of fecal incontinence after surgery. Results in these dogs suggest that fecal incontinence can be associated with spinal cord abnormalities and, depending on the characteristics of the lesion, can resolve after surgical treatment of the abnormality.  相似文献   

17.
The goal of this study was to evaluate the anti‐tumour activity and toxicoses of vinorelbine as a palliative rescue therapy for dogs with primary urinary bladder carcinoma. Thirteen dogs refractory to prior chemotherapeutics and one dog naïve to chemotherapeutic treatment were enrolled. Vinorelbine (15 mg m?2 IV) was administered intravenously along with concurrent oral anti‐inflammatory drugs, if tolerated. A median of six doses of vinorelbine (range: 1–16) was administered. Two dogs (14%) had partial responses, and eight (57%) experienced stable disease. Subjective improvement in clinical signs was noted in 11 dogs (78%). Adverse events were mild and primarily haematological in nature. Median time to progression was 93 days (range: 20–239 days). Median survival time for all dogs was 187 days; median survival for 13 pre‐treated dogs was 207 days. Vinorelbine may have utility in the management of canine primary urinary bladder carcinoma and should be evaluated in a prospective study.  相似文献   

18.
Eleven dogs were diagnosed as having solitary or multiple prostatic cysts in an abdominal, pelvic or perineal position. Common presenting signs included urinary dysfunction, faecal tenesmus and abdominal distension. Cystography was found to be the most consistently accurate technique for differentiating the cysts from the bladder and other abdominal soft tissue masses whilst urethrography often highlighted their prostatic origin. Complete surgical resection of the cysts was attempted in nine dogs, the complexity of dissection being dictated by cyst size and the extent of adhesions to adjacent organs. Nine dogs were castrated. Urinary incontinence continued post-operatively in four dogs but later resolved in three of these. Seven dogs were alive and symptom-free over post-operative periods ranging from one to three years. Despite some of its technical difficulties, surgical excision appears to be a successful approach to even the larger prostatic cysts. Few of the post-operative complications associated with other surgical procedures described for the management of cysts were encountered.  相似文献   

19.
OBJECTIVE: To report synovial cysts associated with cauda equina syndrome in 2 dogs. STUDY DESIGN: Clinical cases. ANIMALS: Two German Shepherd dogs. METHODS: After magnetic resonance imaging detection, cysts were surgically removed via dorsal laminectomy. RESULTS: Six and 8 months after surgery, both dogs were free of clinical signs and no pain was elicited on lumbosacral joint manipulation. CONCLUSION: Although described in dogs, cysts at the lumbosacral joint might cause compression of the cauda equina nerve roots. Radical excision of the cyst capsule can result in resolution of clinical signs. CLINICAL RELEVANCE: Synovial cysts should be considered in the differential diagnosis of dogs with cauda equina compression syndrome when lumbosacral degenerative joint disease is present.  相似文献   

20.
OBJECTIVE: To assess cystoscopic transurethral resection (TUR) for the palliative management of dogs with neoplastic infiltration of the urethra. STUDY DESIGN: Prospective clinical trial. ANIMALS: Six client-owned dogs. METHODS: Cystoscopic examination and electrosurgical TUR were performed in dogs with urination difficulties caused by prostatic or urethral neoplasia. TUR was performed in a retrograde manner in female dogs and antegrade in male dogs via exploratory celiotomy and ventral cystotomy. Cystoscopic examination was used to determine the extent of neoplastic involvement of the urethra. TUR involved piecemeal removal of neoplastic tissue from the urethral lumen using an electrocautery cutting loop. Hemorrhage was controlled with a cystoscopic cauterized roller-ball. In 2 male dogs, intraoperative radiation therapy (IORT) was used to treat both prostatic neoplasia and the sublumbar lymph node bed. Surgical technique, complications, adjuvant treatment, and outcome were recorded. RESULTS: TUR was performed in 3 male dogs with prostatic carcinoma and 2 female dogs with urethral transitional cell carcinoma (TCC). In 1 female dog, TUR was attempted but not successful because of cystoscope diameter. Iatrogenic urethral perforation occurred during TUR in 3 dogs. In 2 dogs, prolonged exposure to lavage fluid resulted in clinical and biochemical abnormalities consistent with TUR syndrome. Dysuria resolved in 5 dogs within 10 days of TUR. Treatment-related complications included urinary tract infection and tumor seeding. Local tumor progression and metastasis occurred in all dogs. CONCLUSIONS: TUR (in combination with chemotherapy+/-IORT) resulted in rapid palliation of urination difficulties in male dogs with prostatic carcinoma. In female dogs with urethral TCC, however, electrosurgical TUR cannot be recommended because of a high intra- and postoperative complication rate with no improvement in postoperative management compared with historical reports of tube cystostomy. CLINICAL RELEVANCE: TUR is a novel alternative for the palliation of male dogs with prostatic carcinoma. In female dogs with urethral TCC, electrosurgical TUR does not provide any advantages compared with tube cystostomy.  相似文献   

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