Department of Clinical Sciences, Ross University, School of Veterinary Medicine, St Kitts; Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA.
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA.
J Equine Vet Sci. 2020 Aug;91:103125. doi: 10.1016/j.jevs.2020.103125. Epub 2020 May 21.
Two mares, aged 15 and 21 years, were examined because of urinary incontinence, intermittent hematuria, and urine scalding. On admission of both horses, physical parameters were within normal limits and urine scalding of the skin at the ventral perineum was noted. Transrectal palpation and cystoscopy revealed a large type I cystolith (>10 cm) with associated hyperemia and focal ulceration of the bladder mucosa. In horse 1, hemogram, serum biochemical analysis, and renal ultrasound were not performed because of owner finances. In horse 2, results from hematological and serum biochemical analysis were unremarkable and renal ultrasonography did not reveal any abnormalities. Pneumatic impact lithotripsy in a laparoscopic retrieval pouch was performed under cystoscopic guidance after caudal epidural anesthesia, with the horses standing and under sedation. A laparoscopic retrieval device was passed alongside a flexible endoscope into the urinary bladder and the cystolith was manipulated into the pouch. A customized single stainless-steel rod scaler attached to an air compressor was used for fragmentation of the cystolith contained within the retrieval pouch. Lithotripsy time was 42 minutes for horse 1 and 31 minutes for horse 2. Both horses were released from hospital the day of surgery. Both horses were continent and voided normal streams of urine for the duration of the follow-up periods of 27 and 19 months for horse 1 and horse 2, respectively. Pneumatic impact lithotripsy in a laparoscopic retrieval pouch provided a time-efficient and minimally invasive surgical treatment option for removal of large cystoliths in mares.
两匹母马，年龄分别为 15 岁和 21 岁，因尿失禁、间歇性血尿和尿液灼伤而接受检查。两匹马入院时，生理参数均在正常范围内，且注意到会阴部皮肤有尿液灼伤。经直肠触诊和膀胱镜检查发现，有一个大的 I 型膀胱结石（>10cm），伴有膀胱黏膜充血和局灶性溃疡。在第一匹马中，由于主人的经济状况，未进行血液学检查、血清生化分析和肾脏超声检查。在第二匹马中，血液学和血清生化分析结果无异常，肾脏超声检查也未发现任何异常。在硬膜外麻醉下，经膀胱镜引导，在腹腔镜回收袋中进行气动冲击碎石术，马处于站立状态并镇静。将柔性内窥镜和腹腔镜回收装置一起穿过膀胱，并将膀胱结石推入回收袋。使用定制的单个不锈钢棒碎石器连接空气压缩机来粉碎回收袋中的膀胱结石。第一匹马的碎石时间为 42 分钟，第二匹马为 31 分钟。两匹马在手术当天都出院了。在随访的 27 个月和 19 个月期间，两匹马均无尿失禁，排尿正常。在腹腔镜回收袋中进行气动冲击碎石术为去除母马的大型膀胱结石提供了一种高效、微创的手术治疗选择。
