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Treatment of traumatic penile urethral stricture in a dog with a self-expanding, covered nitinol stent

Ann-Marie Della Maggiore DVM1, Michele A. Steffey DVM, DACVS2, and Jodi L. Westropp DVM, PhD, DACVIM3
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  • 1 Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.
  • | 2 Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.
  • | 3 Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.

Abstract

Case Description—An 8-month-old castrated male mixed-breed dog was evaluated because of hematuria, stranguria, and dysuria of approximately 2 weeks’ duration that developed immediately following elective castration.

Clinical Findings—Results of physical examination, ultrasonography, retrograde double-contrast cystourethrography, and urethroscopy were consistent with a traumatic urethral stricture immediately proximal to the os penis resulting in a partial obstruction of urine outflow. Results of ultrasonographic examination of abdominal organs were considered normal. Digital radiography revealed no evidence of calculi.

Treatment and Outcome—Balloon dilation of the urethral stricture was performed and was followed by 2 bougienage procedures during the subsequent 2 weeks when clinical signs returned. The owners declined scrotal urethrostomy, and a self-expanding, covered nitinol stent was placed approximately 3 weeks after the initial evaluation, resulting in amelioration of clinical signs. Results of follow-up urethroscopy and contrast cystourethrography 1 year after stent placement revealed a statically positioned, patent urethral stent, although a small number of polypoid mucosal structures were identified distal to the stent and 1 small structure consistent with tissue ingrowth into the stent was identified.

Clinical Relevance—Placement of a covered nitinol stent resulted in long-term resolution of clinical signs associated with traumatic stricture of the penile urethra in this young dog. Because the os penis in dogs limits radial expansion of the urethra, its presence may limit the use of stents in this location.

Abstract

Case Description—An 8-month-old castrated male mixed-breed dog was evaluated because of hematuria, stranguria, and dysuria of approximately 2 weeks’ duration that developed immediately following elective castration.

Clinical Findings—Results of physical examination, ultrasonography, retrograde double-contrast cystourethrography, and urethroscopy were consistent with a traumatic urethral stricture immediately proximal to the os penis resulting in a partial obstruction of urine outflow. Results of ultrasonographic examination of abdominal organs were considered normal. Digital radiography revealed no evidence of calculi.

Treatment and Outcome—Balloon dilation of the urethral stricture was performed and was followed by 2 bougienage procedures during the subsequent 2 weeks when clinical signs returned. The owners declined scrotal urethrostomy, and a self-expanding, covered nitinol stent was placed approximately 3 weeks after the initial evaluation, resulting in amelioration of clinical signs. Results of follow-up urethroscopy and contrast cystourethrography 1 year after stent placement revealed a statically positioned, patent urethral stent, although a small number of polypoid mucosal structures were identified distal to the stent and 1 small structure consistent with tissue ingrowth into the stent was identified.

Clinical Relevance—Placement of a covered nitinol stent resulted in long-term resolution of clinical signs associated with traumatic stricture of the penile urethra in this young dog. Because the os penis in dogs limits radial expansion of the urethra, its presence may limit the use of stents in this location.

Contributor Notes

Presented in abstract form at the 8th Annual Veterinary Endoscopy Society Scientific Meeting, San Pedro, Belize, May 2011.

Address correspondence to Dr. Steffey (masteffey@ucdavis.edu).