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犬完全性单侧重复输尿管畸形的外科治疗及预后

Surgical treatment and outcome of complete unilateral urinary tract duplication in a dog.

机构信息

Eastcott Referrals, Swindon, United Kingdom.

VetCT Consultants in Telemedicine PTY LTD, Fremantle, Western Australia, Australia.

出版信息

Vet Surg. 2020 Dec;49(8):1641-1647. doi: 10.1111/vsu.13505. Epub 2020 Sep 25.

Abstract

OBJECTIVE

To report the surgical technique and outcome for correction of complete unilateral duplication of the left urinary tract in a dog.

ANIMALS

One 7-month-old entire male Jack Russell terrier.

STUDY DESIGN

Case report METHODS: A dog was referred for investigation because of urinary incontinence (UI), preputial irritation (pruritus), diphallia, and cryptorchidism. Computed tomography including urethrographic studies revealed a left duplex kidney, double ectopic left ureters, and a duplex urinary bladder comprising two halves separated by a median septum, each of which emptied into a separate urethra which coursed through separate penises. The left testis was abdominally retained. The right upper urinary tract was considered normal, and the right testis was within the scrotum. Left sided ureteronephrectomy was performed, the median bladder septum was ablated, and the left urethra was ligated. The left penis was partially amputated, and the dog was castrated.

RESULTS

Urinary incontinence was improved but persisted after surgery. After repeat imaging, revision surgery was performed 3 months later in which the distal stumps of the (left) ectopic ureters were found to be filling with urine from the right urethra. Urinary incontinence resolved after resection of these ureteric stumps from the prostate and complete transection of the left urethra.

CONCLUSION

Extensive surgery with resection and correction of urinary tract duplication was successful in resolving UI in this case. Urogenital duplication should be considered a rare cause of UI. The presence of external congenital deformity (eg, diphallia) should alert clinicians to the possibility of significant concurrent internal abnormalities.

摘要

目的

报告一例犬完全性左侧重复输尿管畸形的手术技术和结果。

动物

一只 7 月龄雄性全杰克罗素梗犬。

研究设计

病例报告。

方法

一只犬因尿失禁(UI)、包皮刺激(瘙痒)、双阴茎和隐睾而被转诊。计算机断层扫描(包括尿道造影研究)显示左侧双肾盂、左双异位输尿管和双膀胱,由中间隔分开,每个半部分分别排入单独的尿道,这些尿道分别通过单独的阴茎排出。左侧睾丸位于腹部。右侧上尿路被认为是正常的,右侧睾丸位于阴囊内。行左侧输尿管肾切除术,中间膀胱隔被消融,左侧输尿管被结扎。左侧阴茎被部分切除,犬被去势。

结果

尿失禁在手术后得到改善,但仍持续存在。重复影像学检查后,3 个月后再次行手术,发现(左侧)异位输尿管的远端残端充满来自右侧尿道的尿液。切除这些输尿管残端后,从前列腺到完全横断左侧尿道,尿失禁得到解决。

结论

广泛的手术切除和纠正重复输尿管畸形成功解决了该病例的 UI。尿生殖窦重复畸形应被认为是 UI 的罕见原因。存在外部先天性畸形(如双阴茎)应提醒临床医生注意存在严重的并发内部异常的可能性。

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