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一只雌性犬体内腔内单侧异位输尿管合并输尿管囊肿——临床、诊断及手术方面

Intraluminal unilateral ectopic ureter associated to ectopic ureterocele in a female dog - clinical, diagnostic and surgical aspects.

作者信息

Alves Daniel de Pinho, Fernandes Maria Eduarda Dos Santos Lopes, Lopes Cecília Azevedo Dias, Risso Thainá de Lima, Trindade Mayara do Nascimento, Moreira Thais Marques, Gijsen Isabela Scalioni, Duarte Rodrigo Pereira da Costa

机构信息

Departamento de Medicina e Cirurgia Veterinária, Instituto de Veterinária, Universidade Federal Rural do Rio de Janeiro, Seropédica, RJ, Brazil.

出版信息

Braz J Vet Med. 2025 Mar 18;47:e008424. doi: 10.29374/2527-2179.bjvm008424. eCollection 2025.

DOI:10.29374/2527-2179.bjvm008424
PMID:40104004
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11919245/
Abstract

Ureteral ectopia is a congenital malformation characterized by the abnormal location of the distal aspect of one or both ureters, being classified according to its anatomical path as intramural or extramural. The most common clinical sign is urinary incontinence. The presence of other associated urogenital anomalies, such as hydroureter, hydronephrosis and ureterocele are possible, being the last one a rare condition characterized as a cystic dilation of the submucosal layer of the distal ureter. The diagnosis is based on patient history, clinical signs and imaging exams. Treatment consists in surgical correction, with the technique variating according to the condition classification, and the prognosis is favorable, however most animals remain incontinent. This paper objective to report the diagnostic and clinical surgical conduction of intramural unilateral ectopic ureter correction associated to ectopic ureterocele in a Siberian Husky, 7-months-old, attended at Veterinary Hospital of Federal Rural University of Rio de Janeiro with complaint of urinary incontinence and clinical history of bacterial cystitis. The diagnosis of intramural unilateral ectopia associated with ureterocele was obtained through abdominal ultrasound and excretory urography, being confirmed with surgery. The surgical technique performed was neoureterostomy, and there were no trans or post-surgical intercurrence. Despite maintenance of the ureterocele and right ureter and renal pelvis dilation two days after surgery, observed during abdominal ultrasound, these alterations has positive evolution one week after the surgical procedure. Patient presented significant improvement of urinary incontinence two months after surgery.

摘要

输尿管异位是一种先天性畸形,其特征为一侧或双侧输尿管远端位置异常,根据其解剖路径可分为壁内型或壁外型。最常见的临床症状是尿失禁。其他相关泌尿生殖系统异常,如输尿管积水、肾盂积水和输尿管囊肿也有可能出现,其中输尿管囊肿是一种罕见病症,其特征为输尿管远端黏膜下层的囊性扩张。诊断基于患者病史、临床症状和影像学检查。治疗包括手术矫正,技术会根据病情分类而有所不同,预后良好,不过大多数动物仍会失禁。本文旨在报告一只7个月大的西伯利亚哈士奇壁内型单侧异位输尿管矫正合并异位输尿管囊肿的诊断及临床手术过程,该犬因尿失禁及细菌性膀胱炎病史就诊于里约热内卢联邦农村大学兽医院。通过腹部超声和排泄性尿路造影确诊壁内型单侧异位合并输尿管囊肿,并经手术证实。所施行的手术技术为新输尿管造口术,术中及术后均无并发症。尽管术后两天腹部超声观察到输尿管囊肿以及右侧输尿管和肾盂扩张仍存在,但这些改变在手术后一周有积极进展。术后两个月患者尿失禁情况有显著改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb1f/11919245/d9e8497f8bb1/bjvm-47-e008424-g06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb1f/11919245/56c6c5d5a70b/bjvm-47-e008424-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb1f/11919245/c9601e1a1dee/bjvm-47-e008424-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb1f/11919245/99d8d9345bf1/bjvm-47-e008424-g03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb1f/11919245/4153591e488c/bjvm-47-e008424-g04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb1f/11919245/ac121481aa6a/bjvm-47-e008424-g05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb1f/11919245/d9e8497f8bb1/bjvm-47-e008424-g06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb1f/11919245/56c6c5d5a70b/bjvm-47-e008424-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb1f/11919245/c9601e1a1dee/bjvm-47-e008424-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb1f/11919245/99d8d9345bf1/bjvm-47-e008424-g03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb1f/11919245/4153591e488c/bjvm-47-e008424-g04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb1f/11919245/ac121481aa6a/bjvm-47-e008424-g05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb1f/11919245/d9e8497f8bb1/bjvm-47-e008424-g06.jpg

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本文引用的文献

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Persistent urinary incontinence in female Golden Retrievers following laser ablation of intramural ectopic ureters may be associated with the presence of historical urinary tract infection.雌性金毛猎犬在接受腔内异位输尿管激光消融术后持续性尿失禁可能与既往尿路感染的存在有关。
J Am Vet Med Assoc. 2023 Oct 10;262(1):1-7. doi: 10.2460/javma.23.07.0396. Print 2024 Jan 1.
2
Unilateral Urogenital Disontogeny in a Dog.一只犬的单侧泌尿生殖系统发育异常
Case Rep Vet Med. 2021 Apr 13;2021:8831551. doi: 10.1155/2021/8831551. eCollection 2021.
3
International Society for Companion Animal Infectious Diseases (ISCAID) guidelines for the diagnosis and management of bacterial urinary tract infections in dogs and cats.
国际伴侣动物传染病学会(ISCAID)关于犬猫细菌性尿路感染诊断和管理的指南。
Vet J. 2019 May;247:8-25. doi: 10.1016/j.tvjl.2019.02.008. Epub 2019 Feb 26.
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Canine Incontinence.犬类尿失禁
Vet Clin North Am Small Anim Pract. 2019 Mar;49(2):125-140. doi: 10.1016/j.cvsm.2018.11.003.
5
Diagnostic Imaging of the Urinary Tract.尿路的诊断性影像学检查
Vet Clin North Am Small Anim Pract. 2019 Mar;49(2):261-286. doi: 10.1016/j.cvsm.2018.10.006. Epub 2018 Dec 28.
6
Diagnosis and management of urinary ectopia.尿道异位的诊断与管理
Vet Clin North Am Small Anim Pract. 2014 Mar;44(2):343-53. doi: 10.1016/j.cvsm.2013.11.007.
7
Ectopic ureters in dogs: clinical features, surgical techniques and outcome.犬异位输尿管:临床特征、手术技术及预后
Vet Surg. 2012 May;41(4):515-22. doi: 10.1111/j.1532-950X.2012.00952.x. Epub 2012 Apr 4.
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