Department of Biomedical and Diagnostic Sciences, University of Tennessee College of Veterinary Medicine, University of Tennessee, Tennessee, Knoxville, USA.
Dogs and Cats Veterinary Referral and Emergency Hospital, Maryland, Bowie, USA.
BMC Vet Res. 2021 Feb 9;17(1):73. doi: 10.1186/s12917-021-02780-6.
Ureteral atresia is the congenital absence of a ureteral opening, resulting in a blind-ended ureter that fails to terminate at the urinary bladder. Consequently, severe hydroureter and hydronephrosis occur ipsilateral to the atresic ureter. However, hydronephrosis contralateral to severe hydroureter, although reported in humans, is not documented in the dog. Additionally, ureteral atresia has not been reported as a cause for lower urinary tract signs directly related to extramural urinary bladder compression. This report aims to describe these unique manifestations of this congenital urinary tract disease, as well as follow-up findings after successful treatment.
A 4-month-old male Husky puppy was evaluated for pollakiuria, stranguria, and urine dribbling of 1-month duration. During the physical examination, a mass was palpated in the mid-abdomen. Diagnostic imaging and cystoscopy findings were diagnostic for right-sided ureteral atresia with secondary hydroureter and hydronephrosis. The severe right hydroureter caused lower urinary tract signs and contralateral hydronephrosis secondary to regional compression of the left distal ureter and urinary bladder. A right-sided ureteronephrectomy was performed, resolving the stranguria and pollakiuria. Significant reduction in the contralateral (left) hydronephrosis also occurred.
Ureteral atresia should be considered as a differential diagnosis for lower urinary tract signs and/or bilateral hydronephrosis in a young dog. Reporting this case expands our knowledge of congenital lower urinary tract disease and the etiology of their manifestations in dogs. Surgical resolution of the congenital ureteral abnormality can result in preservation of renal function in the contralaterally obstructed kidney.
输尿管闭锁是输尿管开口的先天性缺失，导致输尿管末端呈盲端，无法终止于膀胱。因此，闭锁输尿管同侧会出现严重的输尿管积水和肾积水。然而，尽管在人类中已有报告称严重输尿管积水对侧发生肾积水，但在犬中尚未有文献记载。此外，输尿管闭锁也未被报道为与异位膀胱压迫直接相关的下尿路症状的原因。本报告旨在描述这种先天性泌尿道疾病的这些独特表现，并介绍成功治疗后的随访结果。
一只 4 月龄雄性哈士奇幼犬因多尿、排尿困难和尿滴沥症状就诊，病程达 1 个月。在体格检查中，于中腹部触诊到一个肿块。诊断性影像学和膀胱镜检查结果提示右侧输尿管闭锁，伴有继发性输尿管积水和肾积水。严重的右侧输尿管积水导致下尿路症状，以及对侧肾积水，这是由于左侧远端输尿管和膀胱的区域压迫所致。进行了右侧输尿管肾切除术，解决了排尿困难和多尿问题。对侧（左侧）肾积水也显著减轻。
输尿管闭锁应作为年轻犬下尿路症状和/或双侧肾积水的鉴别诊断。报告该病例扩展了我们对先天性下尿路疾病及其在犬中表现的病因的认识。先天性输尿管异常的手术解决可导致对侧梗阻肾脏的肾功能得以保留。
