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Evaluation of cystoscopic-guided laser ablation of intramural ectopic ureters in female dogs

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  • 1 Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104.
  • | 2 Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104.
  • | 3 Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104.
  • | 4 Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104.
  • | 5 Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104.
  • | 6 Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104.

Abstract

Objective—To describe and evaluate the short- and long-term outcomes in female dogs after cystoscopic-guided laser ablation of ectopic ureters (CLA-EU).

Design—Prospective case series.

Animals—32 incontinent female dogs with intramural ectopic ureters.

Procedures—A diagnosis of intramural ectopic ureters was made via cystoscopy and fluoroscopy in all patients. Transurethral CLA-EU (via diode laser [n = 27] or Holmium:yttrium aluminum garnet laser [3]) was performed to relocate the ectopic ureteral orifice cranially into the urinary bladder. All vaginal anomalies were treated with the laser concurrently. Follow-up evaluation was standardized and included urinary continence scoring, serial bacteriologic culture of urine samples, and a follow-up cystoscopy 6 to 8 weeks after CLA-EU.

Results—Ectopic ureteral orifices of all dogs were initially located in the urethra. Eighteen of 30 dogs had bilateral ectopic ureters, and 12 had unilateral ectopic ureters. All dogs had other concurrent urinary anomalies. At the time of last follow-up (median, 2.7 years after CLA-EU, [range, 12 to 62 months]), 14 of 30 (47%) dogs did not require any additional treatments following CLA-EU to maintain urinary continence. For the 16 residually incontinent dogs, the addition of medical management, transurethral bulking-agent injection, or placement of a hydraulic occluder was effective in 3, 2, and 4 dogs, respectively, improving the overall urinary continence rate to 77% (23/30 dogs). One dog had evidence of polypoid cystitis at the neoureteral orifice 6 weeks after CLA-EU that was resolved at 3 months.

Conclusions and Clinical Relevance—CLA-EU provided an effective, safe, and minimally invasive alternative to surgery for intramural ectopic ureters in female dogs.

Contributor Notes

Drs. Berent and Weisse and Ms. Wright's present address is Department of Diagnostic Imaging and Interventional Radiology, Animal Medical Center, 510 E 62nd St, New York, NY 10065.

Dr. Mayhew's present address is Department of Surgery, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.

Ms. Todd's present address is Matthew J. Ryan Veterinary Hospital, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104.

Dr. Bagley's present address is Department of Urology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 19107.

Supported in part by a grant from Waltham Pet Nutrition.

Address correspondence to Dr. Berent (Allyson.Berent@amcny.org).