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腹腔镜下输尿管-膀胱再吻合术治疗女性犬输尿管异位致尿失禁:一项初步研究。

Laparoscopic ureteroneocystostomy in the treatment of urinary incontinence due to ectopy of the ureters in female dogs: A pilot study.

机构信息

Department and Clinic of Surgery, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland.

Department of Pediatric Surgery and Urology, Medical University of Wroclaw, Wroclaw, Poland.

出版信息

PLoS One. 2023 Oct 5;18(10):e0292485. doi: 10.1371/journal.pone.0292485. eCollection 2023.

Abstract

Ureteral ectopia is rare and requires surgical treatment after a thorough diagnostic workup. Open surgical techniques for repositioning ectopic ureters have been known for many years and are well described in the literature. However, to the best of our knowledge, no laparoscopic method of correcting this pathology has been described, which, in our opinion, would benefit the animal in terms of the healing process and overall clinical outcomes. This study aimed to evaluate the possibility of laparoscopic treatment of ureteral ectopia, which causes urinary incontinence in dogs. All of the operated ten dogs presented in this study were client-owned females with symptoms of urinary incontinence due to a unilateral intramural ectopic ureter. A three-trocar laparoscopic technique was used to perform the ureteroneocystostomy of the ectopic ureter. In this article, clinicopathological data, imaging features, procedural findings, complications, and short- and long-term outcomes are presented. The procedure was feasible in all cases. No major postoperative complications were observed. Among the minor complications, slight hematuria was observed in three dogs, which resolved spontaneously. In the period of at least one year after surgery, no negative impact of the procedure was observed. Seven of the ten operated dogs regained urinary continence. The remaining three dogs required additional surgery (urethral bulking) because of a lack of improvement after adjuvant pharmacological treatment. Overall, good-to-excellent long-term outcomes can be achieved; however, dogs that remain incontinent after laparoscopic ureteroneocystostomy may require additional treatment.

摘要

输尿管异位是一种罕见的疾病,需要在彻底的诊断检查后进行手术治疗。多年来,人们已经熟知用于重新定位异位输尿管的开放式手术技术,并且这些技术在文献中已有详细描述。然而,据我们所知,目前还没有描述过纠正这种病理的腹腔镜方法,我们认为,从动物的愈合过程和整体临床结果来看,这种方法会对动物有益。本研究旨在评估腹腔镜治疗导致犬尿失禁的输尿管异位的可能性。在本研究中,所有接受手术的 10 只犬均为患有单侧壁内异位输尿管的有症状的宠物犬。采用三套管腹腔镜技术对异位输尿管进行输尿管-膀胱吻合术。本文介绍了临床病理数据、影像学特征、手术过程中的发现、并发症以及短期和长期结果。该手术在所有病例中均可行。未观察到严重的术后并发症。在轻微并发症中,有 3 只犬出现轻微血尿,这些症状均自行缓解。在手术后至少一年的时间内,未观察到手术有任何负面影响。10 只接受手术的犬中有 7 只恢复了尿控。其余 3 只犬由于辅助药物治疗后无改善,需要进行额外的手术(尿道填充术)。总的来说,能够取得良好到极好的长期结果;但是,接受腹腔镜输尿管-膀胱吻合术但仍未恢复尿控的犬可能需要额外的治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ff3/10553214/8d62641d04d3/pone.0292485.g001.jpg

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