Use of cystoscopic-guided laser ablation for treatment of intramural ureteral ectopia in male dogs: four cases (2006–2007)

Allyson C. BerentDepartment of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104-6010.

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Philipp D. MayhewDepartment of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104-6010.

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Yael Porat-MosencoDepartment of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104-6010.

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Abstract

Objective—To describe and evaluate the outcome of cystoscopic-guided laser ablation of intramural ureteral ectopia in male dogs.

Design—Retrospective case series.

Animals—4 incontinent male dogs with intramural ureteral ectopia.

Procedures—Intramural ectopic ureters were diagnosed via preoperative computed tomography–IV urography and subsequent cystoscopy. Transurethral cystoscopic-guided laser ablation (diode laser [n = 3 dogs] and holmium:yttrium aluminum garnet laser [1]) was performed to proximally relocate the ectopic ureteral orifice to the urinary bladder. Fluoroscopy was used during the procedures to confirm that the ureteral tract was intramural and the ureteral orifice was intravesicular after the procedure. In 1 dog with bilateral ureteral ectopia, staged laser ablation was performed at 6-week intervals because of difficulty viewing the second ureter on the first attempt. All ureteral orifices were initially located in the middle to proximal portion of the prostatic portion of the urethra. Six weeks after surgery, imaging was repeated in 3 of 4 dogs.

Results—Postoperative dysuria or hematuria did not develop. All dogs were immediately continent after laser treatment and remained so at a median follow-up period of 18 months (range, 15 to 20 months) without medical management.

Conclusions and Clinical Relevance—Ureteral ectopia can cause urinary incontinence in male dogs and is usually associated with other urinary tract abnormalities. Cystoscopicguided laser ablation provided an effective and minimally invasive alternative to surgical management of intramural ureteral ectopia.

Abstract

Objective—To describe and evaluate the outcome of cystoscopic-guided laser ablation of intramural ureteral ectopia in male dogs.

Design—Retrospective case series.

Animals—4 incontinent male dogs with intramural ureteral ectopia.

Procedures—Intramural ectopic ureters were diagnosed via preoperative computed tomography–IV urography and subsequent cystoscopy. Transurethral cystoscopic-guided laser ablation (diode laser [n = 3 dogs] and holmium:yttrium aluminum garnet laser [1]) was performed to proximally relocate the ectopic ureteral orifice to the urinary bladder. Fluoroscopy was used during the procedures to confirm that the ureteral tract was intramural and the ureteral orifice was intravesicular after the procedure. In 1 dog with bilateral ureteral ectopia, staged laser ablation was performed at 6-week intervals because of difficulty viewing the second ureter on the first attempt. All ureteral orifices were initially located in the middle to proximal portion of the prostatic portion of the urethra. Six weeks after surgery, imaging was repeated in 3 of 4 dogs.

Results—Postoperative dysuria or hematuria did not develop. All dogs were immediately continent after laser treatment and remained so at a median follow-up period of 18 months (range, 15 to 20 months) without medical management.

Conclusions and Clinical Relevance—Ureteral ectopia can cause urinary incontinence in male dogs and is usually associated with other urinary tract abnormalities. Cystoscopicguided laser ablation provided an effective and minimally invasive alternative to surgical management of intramural ureteral ectopia.

Contributor Notes

Supported by Waltham Pet Nutrition.

Address correspondence to Dr. Berent.
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