Transvesicular percutaneous cystolithotomy for the retrieval of cystic and urethral calculi in dogs and cats: 27 cases (2006–2008)

Jeffrey J. Runge Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104.

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Allyson C. Berent Department of Diagnostic and Interventional Radiology, The Animal Medical Center, 510 E 62nd St, New York, NY 10065.

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Philipp D. Mayhew Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.

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Chick Weisse Department of Diagnostic and Interventional Radiology, The Animal Medical Center, 510 E 62nd St, New York, NY 10065.

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Abstract

Objective—To describe the use of transvesicular percutaneous cystolithotomy for the retrieval of cystic and urethral calculi and to report the outcome in dogs and cats.

Design—Retrospective case series.

Animals—23 dogs and 4 cats.

Procedures—Medical records were reviewed for signalment, procedure time, stone number, stone location, pre- and postoperative radiographs, procedure-associated complications, and short-term outcome. A ventral midline approach was made into the abdomen over the urinary bladder apex. A screw cannula was inserted at the bladder apex for normograde rigid and flexible cystourethroscopy. All uroliths were removed via a stone basket device and retrograde flushing and suction. Long-term follow-up (1 year after surgery) information was obtained by telephone or e-mail contact with owners.

Results—27 animals with cystic and urethral calculi were included. Median patient weight was 8.3 kg (18.3 lb; range, 1.8 to 42.6 kg [4.0 to 93.7 lb]). Urolith number ranged from 1 to > 35 (median, 7). Urolith size ranged from < 1 to 30 mm (median, 4.5 mm). Fifteen of the 27 animals had a previous cystotomy (range, 1 to 5 procedures). Median procedure time was 66 minutes (range, 50 to 80 minutes). All patients were discharged within 24 hours. No postoperative complications were reported at the time of suture removal. At the time of long-term follow-up, the 22 clients that could be contacted were satisfied with the procedure.

Conclusions and Clinical Relevance—Transvesicular percutaneous cystolithotomy may decrease the need for urethrotomy, serial transurethral endoscopic procedures, and abdominal insufflation associated with other minimally invasive interventions currently available. This procedure also provided excellent visualization for bladder and urethral luminal inspection.

Abstract

Objective—To describe the use of transvesicular percutaneous cystolithotomy for the retrieval of cystic and urethral calculi and to report the outcome in dogs and cats.

Design—Retrospective case series.

Animals—23 dogs and 4 cats.

Procedures—Medical records were reviewed for signalment, procedure time, stone number, stone location, pre- and postoperative radiographs, procedure-associated complications, and short-term outcome. A ventral midline approach was made into the abdomen over the urinary bladder apex. A screw cannula was inserted at the bladder apex for normograde rigid and flexible cystourethroscopy. All uroliths were removed via a stone basket device and retrograde flushing and suction. Long-term follow-up (1 year after surgery) information was obtained by telephone or e-mail contact with owners.

Results—27 animals with cystic and urethral calculi were included. Median patient weight was 8.3 kg (18.3 lb; range, 1.8 to 42.6 kg [4.0 to 93.7 lb]). Urolith number ranged from 1 to > 35 (median, 7). Urolith size ranged from < 1 to 30 mm (median, 4.5 mm). Fifteen of the 27 animals had a previous cystotomy (range, 1 to 5 procedures). Median procedure time was 66 minutes (range, 50 to 80 minutes). All patients were discharged within 24 hours. No postoperative complications were reported at the time of suture removal. At the time of long-term follow-up, the 22 clients that could be contacted were satisfied with the procedure.

Conclusions and Clinical Relevance—Transvesicular percutaneous cystolithotomy may decrease the need for urethrotomy, serial transurethral endoscopic procedures, and abdominal insufflation associated with other minimally invasive interventions currently available. This procedure also provided excellent visualization for bladder and urethral luminal inspection.

Contributor Notes

Address correspondence to Dr. Runge (jrunge@vet.upenn.edu).
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