Mariano Abigail D, Penninck Dominique G, Sutherland-Smith James, Kudej Raymond K
J Am Vet Med Assoc. 2018 May 1;252(9):1090-1096. doi: 10.2460/javma.252.9.1090.
OBJECTIVE To describe the ultrasonographic appearance of the urinary bladder incision site in dogs that underwent cystotomy for treatment of urolithiasis. DESIGN Prospective, longitudinal study. ANIMALS 18 client-owned dogs. PROCEDURES Dogs underwent urinary bladder ultrasonography at baseline (≤ 1 day before surgery) and at 1 day and approximately 2, 6, and 12 weeks after cystotomy for urocystolith removal. A baseline ratio between ventral (cystotomy site) and corresponding dorsal midline wall thickness was calculated and used to account for measurement variations attributable to bladder distension at subsequent visits. Patient signalment, weight, medications administered, urocystolith composition, and culture results were recorded. Clinical signs, reoccurrence of hyperechoic foci, and suture visualization were recorded at follow-up examinations. Variables were evaluated for association with cystotomy site thickening and resolution of thickening. RESULTS Median wall thickness at the ventral aspect of the bladder was significantly greater than that of the corresponding dorsal aspect at baseline. Cystotomy site thickening peaked 1 day after surgery and decreased at subsequent visits in a linear manner. Twelve weeks after surgery, 5 of 10 clinically normal dogs evaluated had persistent cystotomy site thickening. Eleven of 18 dogs had reoccurrence of hyperechoic foci within the bladder at some time during the study (median time to first detection, 17 days after surgery). CONCLUSIONS AND CLINICAL RELEVANCE Persistent cystotomy site thickening can be present up to 3 months after cystotomy for urolithiasis in dogs without lower urinary tract signs. Reoccurrence of hyperechoic foci in the bladder, although subclinical, was detected earlier and at a higher rate than anticipated.
目的 描述因尿路结石接受膀胱切开术的犬膀胱切口部位的超声表现。 设计 前瞻性纵向研究。 动物 18 只客户拥有的犬。 方法 犬在基线期(手术前≤1 天)以及膀胱切开取石术后 1 天、约 2、6 和 12 周接受膀胱超声检查。计算腹侧(膀胱切口部位)与相应背侧中线壁厚度之间的基线比值,并用于解释后续检查中因膀胱扩张导致的测量差异。记录患者的信号、体重、给药情况、膀胱结石成分和培养结果。在随访检查中记录临床症状、高回声灶的复发情况和缝线可视化情况。评估变量与膀胱切口部位增厚及增厚消退的相关性。 结果 膀胱腹侧壁厚度在基线期显著大于相应背侧壁厚度。膀胱切口部位增厚在术后 1 天达到峰值,并在后续随访中呈线性下降。术后 12 周,评估的 10 只临床正常犬中有 5 只膀胱切口部位持续增厚。18 只犬中有 11 只在研究期间的某个时间膀胱内出现高回声灶复发(首次检测的中位时间为术后 17 天)。 结论及临床意义 对于无下尿路症状的犬,尿路结石膀胱切开术后长达 3 个月可能存在膀胱切口部位持续增厚。膀胱内高回声灶复发虽然为亚临床状态,但比预期更早且更频繁地被检测到。