Use of Electrohydraulic Lithotripsy in 28 Dogs with Bladder and Urethral Calculi

Comparison of percutaneous cystolithotomy and open cystotomy for removal of urethral and bladder uroliths in dogs: Retrospective study of 81 cases (2014-2018)

OBJECTIVE

Compare percutaneous cystolithotomy (PCCL) and open cystotomy (OC) for removal of bladder and urethral uroliths.

DESIGN

Retrospective study.

ANIMALS

Client-owned dogs and cats that underwent PCCL (n = 41) or OC (n = 40) between January 1, 2014 and February 28, 2018 at a referral center.

METHODS

Medical records of dogs and cats that underwent a PCCL or an OC were reviewed. History, signalment, physical examination, diagnostic tests, length of the procedure and anesthesia, complications, and duration of hospitalization were recorded.

RESULTS

A total 17 cats (PCCL = 10; OC = 7) and 64 dogs (PCCL = 31; OC = 33) were included. There was no significant difference, regardless of species, in the mean surgical time (45 min [24-160 min] and 48.5 min [15-122 min] with P = .54 in dogs, P = .65 in cats) nor mean duration of anesthesia (90 min [50-120 min] and 98 min [54-223 min] with P = .87 in dogs, P = .08 in cats) in the PCCL and OC groups respectively. Number of uroliths did not affect duration of surgery in either group. Complete urolith removal was achieved in 98% of dogs and cats in both groups. The median hospitalization time was significantly shorter in the PCCL group for dogs (11.3 hours [range 4 to 51.3] in the PCCL vs 56.6 hours [range 7.3 to 96] in the OC group; P < .001) but did not differ for cats (24.5 hours [range 8.3 to 30] in the PCCL vs 56.6 hours [range 10.1 to 193.2] in the OC group; P = .08).

CONCLUSION AND CLINICAL RELEVANCE

Bladder urolith removal by PCCL procedure is no longer than OC. Further studies are needed to compare the pain related to procedure between PCCL and OC.

Interventional Therapies of the Urinary Tract

Minimally invasive interventional therapies are the new standard of care in veterinary medicine. In comparison with standard surgical procedures, they are associated with minimal tissue injury, leading to shorter, smoother recovery and decreasing the perioperative morbidity and mortality. A thorough understanding of the therapeutic options available is essential to properly educate and inform clients. Proper equipment, technical expertise, and experience are essential prerequisites to many of these procedures.

Cystoscopy in dogs and cats

Cystoscopy has become an important and widely available component of the diagnostic evaluation of diseases of the lower urinary tract in dogs and cats. In addition, a large number of cystoscopic guided procedures have been described that can be used to treat disease processes that were previously treatable only with invasive surgical procedures. This article reviews the indications and contraindications for cystoscopy, cystoscopy equipment and techniques for male and female dogs and cats, potential complications associated with cystoscopy, and management options for these complications.

Urethrotomy of the glans penis in three male dogs with urolithiasis

Three intact male dogs with stranguria and haematuria caused by uroliths in the penile urethra underwent urethrotomy using a novel surgical approach directly over the caudal part of the os penis because conservative procedures to resolve the obstructions had failed. Haemorrhage was minimal, and the incisions healed rapidly by second intention. Complications did not occur during the 6-month follow-up period. Urethrotomy directly over the os penis is straightforward, associated with few complications and holds promise for the removal of urinary calculi in the penile urethra.

Interventional urology: endourology in small animal veterinary medicine

The use of novel image-guided techniques in veterinary medicine has become more widespread, especially in urologic diseases. With the common incidence of urinary tract obstructions, stones disease, renal disease, and urothelial malignancies, combined with the recognized invasiveness and morbidity associated with traditional surgical techniques, the use of minimally invasive alternatives using interventional radiology and interventional endoscopy techniques has become incredibly appealing to owners and clinicians. This article provides a brief overview of some of the most common procedures done in endourology in veterinary medicine to date, providing as much evidence-based medicine as possible when comparing with traditional surgical alternatives.

Influence of Ureteral Stone Components on the Outcomes of Electrohydraulic Lithotripsy

Purpose

We evaluated the influence of urinary stone components on the outcomes of ureteroscopic removal of stones (URS) by electrohydraulic lithotripsy (EHL) in patients with distal ureteral stones.

Materials and Methods

Patients with a single distal ureteral stone with a stone size of 0.5 to 2.0 cm that was completely removed by use of EHL were included in the study. Operating time was defined as the time interval between ureteroscope insertion and complete removal of ureteral stones. Ureteral stones were classified into 5 categories on the basis of their main component (that accounting for 50% or more of the stone content) as follows: calcium oxalate monohydrate (COM), calcium oxalate dihydrate, carbonate apatite (CAP), uric acid (UA), and struvite (ST).

Results

A total of 193 patients (131 males and 62 females) underwent EHL. The mean operating time was 25.1±8.2 minutes and the mean stone size was 1.15±0.44 cm. Calcium oxalate stones accounted for 64.8% of all ureteral stones, followed by UA (19.7%), CAP (8.3%), and ST (7.2%) stones. The mean operating time was significantly longer in the UA group (28.6±8.3 minutes) than in the COM group (24.0±7.8 minutes, p=0.04). In multivariate analyses, the stone size was negatively associated with the odds ratio (OR) for successful fragmentation. UA as a main component (OR, 0.42; 95% confidence interval, 0.20 to 0.89; p=0.023) was also found to be significantly important as a negative predictive factor of successful fragmentation after adjustment for stone size.

Conclusions

The results of the present study suggest that successful fragmentation by URS with EHL could be associated with the proportion of the UA component.

Diagnostic rigid endoscopy: otoscopy, rhinoscopy, and cystoscopy

Diagnostic examinations are markedly improved by using rigid endoscopy in the ear, nasal cavity, and urinary tract. This article presents the procedure, equipment, indications, and examples of abnormalities of rigid endoscopy in these areas. Textbooks, "hands-on" courses, and in-hospital training are methods for learning about these techniques and their applications. In addition to improving diagnostics, endoscopy can also be used for therapy in these three body areas.