Parkinson Lily A B, Hausmann Jennifer C, Hardie Robert J, Mickelson Megan A, Sladky Kurt K
J Am Vet Med Assoc. 2017 Dec 1;251(11):1313-1317. doi: 10.2460/javma.251.11.1313.
CASE DESCRIPTION A 5-year-old sexually intact female guinea pig was evaluated because of mild dysuria and a subcutaneous mass located cranioventral to the urogenital openings. CLINICAL FINDINGS Non-contrast-enhanced CT and surgical exploration of the distal aspect of the urethra revealed a urethral diverticulum with an intraluminal urolith. Analysis revealed that the urolith was composed of calcium carbonate and struvite. TREATMENT AND OUTCOME The urolith was surgically removed and ablation of the urethral diverticulum was attempted. Approximately 3 months later, the guinea pig was reevaluated for masses in the perineal region, and positive-contrast urethrocystography revealed 2 uroliths present in the same diverticulum. Uroliths were manually expressed with the patient under general anesthesia. Approximately 2 weeks later, urethroplasty was performed to create an enlarged stoma with the diverticulum, thereby preventing urine from pooling in the diverticulum and potentially reducing the risk of future urolith formation. The urethroplasty site healed well with no reported complications or evidence of urolith recurrence 6 months after surgery. CLINICAL RELEVANCE Urolithiasis is common in guinea pigs, and urethral diverticulum and intraluminal urolith formation should be considered as a potential differential diagnosis for a subcutaneous mass along the distal aspect of the urethra. Creation of a urethral stoma from a urethral diverticulum via urethroplasty achieved a successful outcome in this patient.
一只5岁未绝育的雌性豚鼠因轻度排尿困难以及泌尿生殖孔前方腹侧皮下有一肿块而接受评估。
非增强CT及尿道远端的手术探查发现一个尿道憩室,憩室内有一枚尿道结石。分析显示该尿道结石由碳酸钙和鸟粪石组成。
通过手术取出结石,并尝试对尿道憩室进行切除。大约3个月后,对这只豚鼠会阴区域的肿块进行复查,阳性造影剂尿道膀胱造影显示同一个憩室内有2枚结石。在全身麻醉下对豚鼠进行手法挤石。大约2周后,实施尿道成形术以扩大与憩室相连的造口,从而防止尿液在憩室内积聚,并可能降低未来形成尿道结石的风险。尿道成形术部位愈合良好,术后6个月无并发症报告,也无尿道结石复发迹象。
尿路结石在豚鼠中很常见,尿道憩室和憩室内尿道结石形成应被视为尿道远端皮下肿块的潜在鉴别诊断。通过尿道成形术从尿道憩室创建尿道造口在该病例中取得了成功。