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1.
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
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
2.
Urethral obstruction in a male llama 总被引：1，自引：0，他引：1
B G McLaughlin N C Evans 《Journal of the American Veterinary Medical Association》1989,195(11):1601-1602
An 8-year-old sexually intact male llama was euthanatized because of obstruction of the penile portion of the urethra and rupture of the urinary bladder. Clinical signs of obstruction included anorexia, lethargy, teeth grinding, straining to defecate, inability to urinate, and tense abdomen. Laboratory findings included anemia, leukocytosis with left shift, high serum urea nitrogen, creatinine, and phosphorus concentrations, and low serum chloride concentration. Necropsy revealed ruptured urinary bladder and acute fibrinous peritonitis. A firm, gray, nonmineralized urethral plug occluded the penile portion of the urethra for a distance of 14 cm in the midpenile region, distal to the sigmoid flexure of the penis. The urinary bladder mucosa and the urethra had microscopic evidence of chronic inflammation. Escherichia coli, Klebsiella sp, and alpha-streptococci were isolated from the urethral plug. 相似文献
3.
The clinical features and interventional therapy in the case of a female cat with urinary tract obstruction secondary to neoplasia are presented. This form of neoplasia in cats is rare and therapeutic intervention to relieve urinary tract obstruction caused by malignancy has been described only once. This is the first report of a self-expandable metallic stent placed in a feline urethra to relieve obstruction caused by malignancy and the first report of the use of a unique composite metallic stent (Platinol™) in a cat. In conclusion, the palliative stenting of the feline urethra may be a valid therapeutic intervention for malignancies. Further studies are required to determine the optimal size and type of stent that will provide the greatest benefit. 相似文献
4.
Experimental matrix plug production in male cat urine following a natural case of urolithiasis due to matrix plug 总被引：1，自引：0，他引：1
Urethral obstruction occurred in a 2-year-old entire long-haired red cat. A suspicion that this was a case caused by matrix plug formation could not be confirmed as reverse flushing using a topical corticosteroid and a trypsin digest appeared to have broken up the obstruction. Nine days later the cat passed a large mucoid mass which, when placed into a simulated urethra produced an obstruction. Histological examination of this plug confirmed that there were no crystalline components and on appearance it was similar to that of natually occurring matrix plugs. 相似文献
5.
Urinary acidification in the prevention and treatment of feline struvite urolithiasis 总被引：2，自引：0，他引：2
G F Taton D W Hamar L D Lewis 《Journal of the American Veterinary Medical Association》1984,184(4):437-443
Two groups of 12 cats were fed ad libitum an experimental dry expanded ration high in magnesium (0.37%, dry matter basis) and similar to most commercial dry cat foods in all other nutrients. The diet of one of the groups contained 1.5% ammonium chloride, which was added to the diet before processing. Urethral obstruction developed twice in 7 of the 12 cats fed the ration without ammonium chloride. Of the 5 remaining cats in that group, 2 had calculi in the urinary bladder and urethra at necropsy. In contrast, only 2 of the 12 cats fed the ration containing ammonium chloride had urethral blockage once; neither cat had another blockage. Both cats had been catheterized twice as paired controls before urethral obstruction. One of these 2 cats died from a urinary tract infection apparently introduced through the indwelling catheter, and at necropsy there were 2 small calculi in the urethra. At the end of the study, only 1 other cat fed the ammonium chloride diet had a calculus in the urinary bladder at necropsy; this cat had not had a urethral obstruction throughout the study. After each cat had 2 urethral blockages, its diet was changed. Four cats were fed the ration containing ammonium chloride and 3, a dry, commercial ration. Of the 4 cats fed the diet containing ammonium chloride, none developed another urethral obstruction within 6 months, and at necropsy, no calculi were in the urinary bladder or urethra. Two of the 3 cats fed the commercial ration experienced urethral blockage within 3 months. These 2 cats were then fed the diet containing ammonium chloride.(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献
6.
A modified perineal urethrostomy was performed in 14 males cats with partial or complete urethral obstruction. Follow-up information was available for 2 to 18 months. By use of this method, the preputial tissues were preserved, and the penile urethra was anastomosed to the preputial mucosa to enlarge and lengthen the urethra. Urine flow was reestablished in all cats without evidence of urethral stenosis or other major complications. Appearance of the perineal region and prepuce was not substantially altered. 相似文献
7.
Perineal urinary bladder diverticulum resulting in partial urinary obstruction in a rhesus monkey. 总被引：1，自引：0，他引：1
D J Gaertner B Lytton S Morgenstern 《Journal of the American Veterinary Medical Association》1991,199(12):1772-1774
A 16-year-old rhesus monkey with perineal swelling and urinary obstruction was found to have a congenital urinary bladder diverticulum. Because the diverticulum was located at the trigone, its distention partially obstructed the urethra, resulting in incomplete voiding. The diverticulum was resected and did not redevelop. 相似文献
8.
A 9-year-old intact male cat was presented for vomiting and straining to defecate. A large abdominal mass was palpated. The urinary bladder was full and non-expressible. Exploratory laparotomy revealed that the mass was compressing the colon and encircling the urethra caudal to the bladder. The mass was removed, the urethra transected, and the urinary bladder marsupialized to the ventral abdominal wall to allow urine drainage. Histopathologic examination of the mass revealed a prostatic carcinoma. The cat died approximately 6 weeks after removal of the mass. This is the first reported case of a prostatic carcinoma causing urethral obstruction and obstipation in a cat. 相似文献
9.
Julia B. Montgomery Wendy M. Duckett Andrea C. Bourque 《The Canadian veterinary journal. La revue veterinaire canadienne》2009,50(7):751-754
A 6-year-old mare was presented for evaluation of dysuria and pollakiuria. A
pelvic mass, which caused obstruction of urinary outflow, was identified.
Evidence of renal failure was also present. Due to poor prognosis the mare was
euthanized. A postmortem examination revealed a pelvic lymphoma that surrounded
and compressed the urethra. 相似文献
10.
P M Moreau G E Lees H P Hobson 《Journal of the American Veterinary Medical Association》1983,183(10):1084-1088
A recently developed urodynamic testing procedure was used to evaluate disorders of micturition in 2 dogs. The procedure simultaneously recorded intravesical pressure and urine flow during micturition. In an 11-year-old spayed female Sheltie that could not urinate normally, a micturition study demonstrated functional outflow obstruction of the urinary bladder. Although the urethra was patent, the urethral resistance factor, as calculated from pressure and flow data, was extremely high during voiding efforts. A urethral transitional cell carcinoma along with secondary infection, inflammation, and fibrosis were found to be responsible for the dog's problem. Ability to urinate was restored following removal of the affected portion of the urethra. In a 6-year-old spayed female Doberman Pinscher with urinary incontinence during sleep, a micturition study demonstrated urethral incompetence. During infusion of 0.9% NaCl solution into the bladder, the fluid flowed through the urethra before the detrusor muscle contracted, and urethral resistance during voiding was low. The dog's incontinence was responsive to estrogen administration. 相似文献
11.
Urethral leiomyoma in a cat 总被引：1，自引：0，他引：1
K M Swalec D D Smeak A L Baker 《Journal of the American Veterinary Medical Association》1989,195(7):961-962
A 13-year-old spayed cat was examined because of a suspected lower urinary tract obstruction. After 2 days, a urethral catheter could not be passed, and the cat was euthanatized. At necropsy, a 1.2-cm intramural mass was detected, obstructing the proximal portion of the urethra. Histologic examination of the well-circumscribed mass revealed a urethral leiomyoma. 相似文献
12.
An eight-year-old male Australian cattle dog cross was presented with complete urethral obstruction secondary to fracture of the os penis which had occurred two years earlier. Obstruction was associated with callus and fibrous tissue proliferation compressing the urethra at the fracture site. The problem was satisfactorily resolved by removing excess bone and fibrous tissue and stabilising the fracture with a stainless steel finger plate. 相似文献
13.
This case report records an obstructive urolithiasis due to a large calcium carbonate urethral stone in an 11-year-old Arabian stallion. The stallion had colicky pain, anuria, and reduction in food and water intakes. Palpation of the penis revealed rhythmic contractions of the urethra, a hard mass in the penile urethra at the level of the ischial arch, and a dilated urethra proximal to the mass. Rectal examination revealed a distended and turgid urinary bladder. Passing a urethral catheter revealed a complete urethral obstruction at the level of the ischial arch. Ultrasonography revealed a calculus that appeared as an irregular, hyperechoic arch-like thick line with acoustic shadowing. Subischial urethrotomy was conducted under epidural anesthesia. Uneventful recovery was seen with no recurrence or complications for 12 months of available follow-up. In conclusion, clinical, rectal, and ultrasound examinations are valuable for definite diagnosis of urethral calculi in horses and the subischial urethrotomy appears to be successful in correcting this condition in horses. 相似文献
14.
Lane IF Fischer JR Miller E Grauer GF Lappin MR 《Journal of veterinary internal medicine / American College of Veterinary Internal Medicine》2000,14(1):43-49
Three dogs with dysuria and urine retention caused by excessive functional urethral resistance are described. All dogs had clinical histories and urologic signs that previously would have been classified as detrusor-urethral dyssynergia. Diagnosis of functional urinary obstruction was established by exclusion of anatomic urinary obstruction and confirmed by urethral pressure profilometry. In 2 cases, multiple pressure deflections recorded in the urethral pressure profile suggested spasm of urethral musculature, whereas in a 3rd dog, abnormally high pressures were recorded along a portion of the proximal urethra. Functional urinary obstruction was associated with prostatitis in 1 dog and with a history of urethral calculi in 1 dog, and no underlying disorder could be identified in the remaining dog. All 3 dogs improved with medical treatments that included alpha adrenergic antagonists. The etiology, diagnosis, and pharmacologic management of functional urinary obstruction are discussed. 相似文献
15.
PETER C. RAKESTRAW MA VMD Diplomate ACVS SUSAN L. FUBINI DVM Diplomate ACVS ROBERT O. GILBERT BVSc M MED VET Diplomate ACT JEFFREY O. WARD DVM 《Veterinary surgery : VS》1995,24(6):498-505
Tube cystostomy was used to treat 13 goats and two sheep with obstructive urolithiasis. The cystostomy tube was intermittently occluded 3 to 4 days after placement to determine if urine could be voided through the urethra. If the animal showed no discomfort during urination after the cystostomy tube had been occluded for several days, the tube was removed. This procedure was successful in relieving urethral obstruction in 12 animals. The mean time until the animal could urinate freely and until the cystostomy tube was removed was 11.5 and 14.4 days respectively. Follow-up was available for 10 animals; seven were alive with no recurrence of urinary obstruction. One goat died from causes unrelated to urinary obstruction 1 year postoperatively. One goat died from unknown causes, and one goat died after urinary obstruction recurred. 相似文献
16.
An unusual cause of urethral obstruction in the dog 总被引：1，自引：0，他引：1
H. R. Denny 《The Journal of small animal practice》1972,13(6):339-341
17.
Gabriella Sfiligoi DVM Kenneth J. Drobatz DVM MSCE DACVIM DACVECC H. Mark Saunders VMD MS DACVR 《Journal of Veterinary Emergency and Critical Care》2006,16(1):50-53
A 6‐year‐old, male castrated domestic short hair cat presented for urethral obstruction. Despite passage of a urinary catheter, urine could not be drained through the catheter, but urine flow was noted around the catheter. Special imaging studies, including ultrasound and fluoroscopy, revealed that the catheter had been passed into an abnormal small bicornuate structure that entered the urethra from dorsally within the pelvic canal. This structure was believed to be a uterus masculinus or remnants of the Mullerian ducts. The anomalous structure was not felt to be related to the cause of the urethral obstruction, but was simply an incidental finding which resulted in difficult catheterization. 相似文献
18.
The mucosal margin of the urethra is best assessed by positive contrast urethrography, but ultrasonography offers complementary information such as urethral wall thickness and size of medial iliac lymph nodes. Ultrasonography of the urethra is quick, noninvasive and does not require sedation or general anesthesia. In patients with complete urethral obstruction, ultrasonography may be the only way to image the urethra. Twelve dogs which were presented to Tufts University School of Veterinary Medicine with clinical signs referable to the urinary bladder, urethra or vagina were examined ultrasonographically. Seven were neutered females and five were neutered males. Each dog had a hyperechoic, nonshadowing line at the epithelial surface of the proximal urethra. In the seven female patients and one of the males, the urethral wall was also thick and hypoechoic to surrounding tissue. In the other males, the urethral epithelial changes were at the level of the prostate, and the limits of the urethra were not visible. In six dogs, the urethral change was the only abnormality seen, while in six, bladder wall, bladder luminal and/or prostatic parenchymal changes were also detected. Three patients had hydronephrosis, and one had enlarged medial iliac lyumph nodes. Biopsies were obtained via suction with urinary catheterization (n = 6), exploratory celiotomy (n = 3), urethroscopy (n = 2), or at post-mortem (n = 1). A histopathologic diagnosis of urethral transitional cell carcinoma was obtained in ten dogs. The ultrasonographic appearance was not pathognomonic for transitional cell carcinoma, as one dog with transitional cell dysplasia and one dog with severe ulcerative and necrosupperative cystitis and urethral stricture had similar findings. 相似文献
19.
Urethral obstruction is a potentially fatal condition and in cases of recurrent obstruction or an identified cause that is refractory to medical management, a urethrostomy may be performed for definitive treatment. Perineal urethrostomy is the surgical creation of a permanent stoma in the wider pelvic urethra via anastomosis to the perineal skin. Diagnosis of the underlying cause of obstruction, proper perioperative treatment, and an understanding of the anatomy and surgical technique, are imperative to the success of this procedure. This review intends to highlight these aspects, as well as the common complications and expected prognosis to aid decision making in the management of these cases. 相似文献
20.
Elwick KE Melendez LD Higbee RG Blaik MA Ritchey JW Lucroy MD 《Journal of the American Animal Hospital Association》2003,39(5):506-508
A miniature schnauzer presented for evaluation of a persistent lower urinary tract obstruction. Further examination revealed that the dog had developed an obstructive, inflammatory polyp secondary to a long-standing urinary tract infection. The polyp was located within the proximal urethra and interfered with normal voiding. The polyp was visualized using flexible endoscopy and then was successfully ablated using the neodymium:yttrium-aluminum-garnet (Nd:YAG) laser. The Nd:YAG laser is a potentially useful tool for treating various lesions of the lower urinary tract. 相似文献