Jones Andrew R E, Ragle Claude A
J Am Vet Med Assoc. 2018 Dec 1;253(11):1467-1472. doi: 10.2460/javma.253.11.1467.
CASE DESCRIPTION 2 fillies, aged 3 months and 1 month, were examined because of urinary incontinence and urine scalding. CLINICAL FINDINGS In horse 1, ultrasonography did not reveal any structural abnormalities of the kidneys; however, unilateral ureteral ectopia was diagnosed cystoscopically. In horse 2, CT revealed bilateral nephropathy, bilateral distended ureters (up to 3.6 cm in diameter), and bilateral ureteral ectopia. Cystoscopy revealed intramural ureteral ectopia with abnormally caudally positioned ureteral ostia in both horses. TREATMENT AND OUTCOME Ureteral ostioplasty was performed under cystoscopic guidance. Laparoscopic scissors (horse 1) or a vessel-sealing device (horse 2) was introduced, and the tissue separating the intramural portion of the ureter from the urethra and bladder was cut longitudinally in a cranial direction toward the trigone. After surgery, both horses were continent and voided normal streams of urine for the duration of the follow-up periods of 20 and 9 months for horse 1 and horse 2, respectively. CLINICAL RELEVANCE Cystoscopically guided ureteral ostioplasty provided an effective and minimally invasive surgical treatment option for correction of ureteral ectopia in 2 fillies.
两匹分别为3个月和1个月大的小母马因尿失禁和尿液烫伤接受检查。临床发现：在第1匹马中，超声检查未发现肾脏有任何结构异常；然而，经膀胱镜检查诊断为单侧输尿管异位。在第2匹马中，CT显示双侧肾病、双侧输尿管扩张（直径达3.6厘米）和双侧输尿管异位。膀胱镜检查显示两匹马均存在壁内输尿管异位，输尿管口位置异常靠尾侧。治疗与结果：在膀胱镜引导下进行输尿管造口术。引入腹腔镜剪刀（第1匹马）或血管封闭装置（第2匹马），将输尿管壁内部与尿道和膀胱分隔的组织沿头侧方向纵向切开至三角区。术后，两匹马均能自主控制排尿，在第1匹马和第2匹马分别为期20个月和9个月的随访期内，尿液排出正常。临床意义：膀胱镜引导下输尿管造口术为矫正两匹小母马的输尿管异位提供了一种有效且微创的手术治疗选择。
