Dekerle Bastien, Maurice Emeline, Decambron Adeline, Viateau Véronique, Maurey Christelle, Manassero Mathieu
Department of Surgery, ChuvA, École Nationale Vétérinaire d'Alfort, Maisons-Alfort, France.
Department of Internal Medicine, ChuvA, École Nationale Vétérinaire d'Alfort, Maisons-Alfort, France.
Vet Surg. 2022 May;51(4):568-575. doi: 10.1111/vsu.13807. Epub 2022 Mar 29.
To report outcomes after the correction of ectopic ureter (EU) by open surgery or cystoscopic-guided laser ablation (CLA) in female dogs.
Retrospective study from 2011 to 2018.
Twenty-five female dogs.
Data collected included signalment, clinicopathologic data, procedural data, complications, and short-term and long-term outcomes. Complications were graded as minor or major if a surgical revision was required. Continence status was scored subjectively (1 = completely incontinent to 10 = fully continent).
Fifteen dogs had bilateral EU and 24 had intramural EU (iEU). Open surgical correction included 13 neoureterostomies, 2 neocystoureterostomies, and a combination of these in 2 dogs. Eight dogs underwent CLA. Eighteen dogs experienced minor complications (72%), and 2 experienced major complications (8%). One-month postoperative continence was achieved in 20/25 (80%) dogs (median score of 10). Incontinence recurred at a median time of 24.9 months in 5 dogs but responded to medical treatment. Overall, dogs remained continent for 66 months (median) and 22/25 (88%) dogs achieved continence with adjunction of medical/surgical treatment in incontinent ones. Fewer minor complications and postoperative recurrences of incontinence were documented after CLA than neoureterostomy (P < .01 and P < .05).
Ectopic ureter correction by open surgery or CLA resulted in a subjectively good prognosis, most dogs reaching continence within a month of surgery, although incontinence occasionally recurred in the long term. CLA was associated with fewer complications and incontinence recurrences than neoureterostomy.
Cystoscopic-guided laser ablation should be preferred to correct iEU to prevent short-term complications and the recurrence of incontinence. Further studies should investigate the cause of postoperative recurrence of urinary incontinence.
报告雌性犬开放性手术或膀胱镜引导下激光消融术(CLA)矫正异位输尿管(EU)后的结果。
2011年至2018年的回顾性研究。
25只雌性犬。
收集的数据包括特征、临床病理数据、手术数据、并发症以及短期和长期结果。如果需要手术修正,则将并发症分为轻度或重度。自主排尿状态采用主观评分(1 = 完全失禁至10 = 完全自主排尿)。
15只犬为双侧EU,24只为壁内EU(iEU)。开放性手术矫正包括13例新输尿管造口术、2例新膀胱输尿管造口术以及2只犬采用了这两种手术的联合。8只犬接受了CLA。18只犬出现轻度并发症(72%),2只出现重度并发症(8%)。20/25(80%)只犬术后1个月实现自主排尿(中位评分为10分)。5只犬在中位时间24.9个月时尿失禁复发,但对药物治疗有反应。总体而言,犬保持自主排尿状态的时间为66个月(中位时间),22/25(88%)只犬在失禁时通过药物/手术治疗辅助实现了自主排尿。与新输尿管造口术相比,CLA术后记录到的轻度并发症和尿失禁复发较少(P < 0.01和P < 0.05)。
开放性手术或CLA矫正异位输尿管导致主观预后良好,大多数犬在手术后1个月内达到自主排尿,尽管尿失禁偶尔会在长期复发。与新输尿管造口术相比,CLA相关的并发症和尿失禁复发较少。
膀胱镜引导下激光消融术应优先用于矫正iEU,以预防短期并发症和尿失禁复发。进一步的研究应调查术后尿失禁复发的原因。