• 1. Ragle CA. Dorsally recumbent urinary endoscopic surgery. Vet Clin North Am Equine Pract 2000; 16:343350.

  • 2. Wilson DV, Bohart GV, Evans AT, et al. Retrospective analysis of detomidine infusion for standing chemical restraint in 51 horses. Vet Anaesth Analg 2002; 29:5457.

    • Search Google Scholar
    • Export Citation
  • 3. Natalini CC. Spinal anesthetics and analgesics in the horse. Vet Clin North Am Equine Pract 2010; 26:551564.

  • 4. Usenik EA, Larson LL, Sauer F. Cystotomy and removal of a urolith in a Shetland mare. J Am Vet Med Assoc 1956; 128:453.

  • 5. Lowe JE. Suprapubic cystotomy in a gelding. Cornell Vet 1960; 50:510514.

  • 6. Wright JG, Neal PA. Laparo-cystotomy for urinary calculus in a gelding. Vet Rec 1960; 72:301303.

  • 7. Lowe JE. Surgical removal of equine uroliths via the laparocystotomy approach. J Am Vet Med Assoc 1961; 139:345348.

  • 8. Crabbe BG, Bohn AA, Grant BD. Equine urocystoliths. Equine Pract 1991; 13:1217.

  • 9. Kaneps AJ, Shires GM, Watrous BJ. Cystic calculi in two horses. J Am Vet Med Assoc 1985; 187:737739.

  • 10. Lowe JE. Long-term results of cystotomy removal of uroliths from horses. J Am Vet Med Assoc 1965; 147:147.

  • 11. Mair TS, McCaig J. Cystic calculus in a horse. Equine Vet J 1983; 15:173174.

  • 12. Williams KR. Laparocystotomy in a gelding. Vet Rec 1964; 76:8384.

  • 13. Holt PE, Pearson H. Urolithiasis in the horse—a review of 13 cases. Equine Vet J 1984; 16:3134.

  • 14. Beard W. Parainguinal laparocystotomy for urolith removal in geldings. Vet Surg 2004; 33:386390.

  • 15. Watts AE, Fubini SL. Modified parainguinal approach for cystic calculus removal in five equids. Equine Vet J 2012; 45:9496.

  • 16. Röcken M, Stehle C, Mosel G, et al. Laparoscopic-assisted cystotomy for urolith removal in geldings. Vet Surg 2006; 35:394397.

  • 17. Straticò P, Suriano R, Sciarrini C, et al. Laparoscopic-assisted cystotomy and cystostomy for treatment of cystic calculus in a gelding. Vet Surg 2012; 41:634637.

    • Search Google Scholar
    • Export Citation
  • 18. Judy CE, Galuppo LD. Endoscopic-assisted disruption of urinary calculi using a holmium: YAG laser in standing horses. Vet Surg 2002; 31:245250.

    • Search Google Scholar
    • Export Citation
  • 19. Röcken M, Fürst A, Kummer M, et al. Endoscopic-assisted electrohydraulic shockwave lithotripsy in standing sedated horses. Vet Surg 2012; 41:620624.

    • Search Google Scholar
    • Export Citation
  • 20. MacHarg MA, Foerner JJ, Phillips TN, et al. Electrohydraulic lithotripsy for treatment of a cystic calculus in a mare. Vet Surg 1985; 14:325327.

    • Search Google Scholar
    • Export Citation
  • 21. Dongen PL, Plenderleith RW. Equine urolithiasis: surgical treatment by Gökels pararectal cystotomy. Equine Vet Educ 1994; 6:186188.

    • Search Google Scholar
    • Export Citation
  • 22. Abuja GA, García-Löpez JM, Doran R, et al. Pararectal cystotomy for urolith removal in nine horses. Vet Surg 2010; 39:654659.

  • 23. Laverty S, Pascoe JR, Ling GV, et al. Urolithiasis in 68 horses. Vet Surg 1992; 21:5662.

  • 24. Ragle CA. Management of bladder uroliths. In: Robinson NE, Sprayberry KA, eds. Current therapy in equine medicine. 6th ed. Philadelphia: Saunders; 2008; 741744.

    • Search Google Scholar
    • Export Citation
  • 25. Ragle CA. Decision-making and options: surgical approach and repair of the equine bladder. Equine Vet Educ 2008; 20:191193.

  • 26. Russell T, Pollock PJ. Local anesthesia and hydro-distension to facilitate cystic calculus removal in horses. Vet Surg 2012; 41:638642.

    • Search Google Scholar
    • Export Citation
  • 27. Anderson DE, Schulz KM, Rousseau M. Laparoscopic cystotomy for removal of a large bladder polyp in a juvenile alpaca with polypoid cystitis. Vet Surg 2010; 39:733736.

    • Search Google Scholar
    • Export Citation
  • 28. Kim JH, Doo SW, Yang WJ, et al. Laparoscopic transvesical excision and reconstruction in the management of mid-urethral tape mesh erosion and stones around the bladder neck: initial experiences. BJU Int 2012; 110:10091013.

    • Search Google Scholar
    • Export Citation
  • 29. Brun MV, Oliveira ST, Messina SA, et al. Laparoscopic cystotomy for urolith removal in dogs: three case reports. Arg Bras Med Vet Zootec 2008; 60:103108.

    • Search Google Scholar
    • Export Citation
  • 30. Ragle CA, Fransson BA. Fundamental laparoscopic skills. In: Ragle CA, ed. Advances in equine laparoscopy. Ames, Iowa: Wiley-Blackwell, 2012; 1320.

    • Search Google Scholar
    • Export Citation
  • 31. Ragle C. Bladder stones: laparoscopic approach, in Proceedings. Am Coll Vet Surg Symp 2005; 127129.

  • 32. Adams R, Koterba AM, Cudd TC, et al. Exploratory celiotomy for suspected urinary tract disruption in neonatal foals: a review of 18 cases. Equine Vet J 1988; 20:1317.

    • Search Google Scholar
    • Export Citation
  • 33. Hardy J. Uroabdomen in foals. Equine Vet Educ 1998; 10:2125.

  • 34. McGee SM, Routh JC, Pereira CW, et al. Minimal contamination of the human peritoneum after transvesical incision. J Endourol 2009; 23:659663.

    • Search Google Scholar
    • Export Citation

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Laparoscopic removal of a bladder urolith in a standing horse

Caleb M. Lund DVM1, Claude A. Ragle DVM, DACVS, DABVP2, and J. Dylan Lutter DVM3
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  • 1 Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA 99164.
  • | 2 Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA 99164.
  • | 3 Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA 99164.

Abstract

Case Description—An 11-year-old Arabian gelding was evaluated for hematuria, stranguria, and pollakiuria that had been observed for 1 week.

Clinical Findings—Transrectal palpation revealed a 5-cm firm round mass in the urinary bladder. Cystoscopy and transrectal ultrasonography confirmed the diagnosis of urinary bladder urolithiasis.

Treatment and Outcome—A multiportal transparalumbar fossa laparoscopic approach was selected for cystotomy and urolith removal. Cystotomy and urolith removal was performed with sedation and local anesthesia with the horse standing. No perioperative complications were observed. Urination returned to normal 5 days after surgery. The horse returned to its previous level of activity at 3 weeks after surgery.

Clinical Relevance—Findings suggested that minimally invasive transparalumbar fossa laparoscopic approach can be successfully used for cystotomy and urolith extraction in standing horses; this avoids the disadvantages of conventional laparocystotomy for removal of large uroliths in male equids and the potential complications of general anesthesia and recovery. The technique provided excellent viewing and access to the bladder, permitting extraction of the urolith and secure closure of the cystotomy with minimal tension and tissue trauma to the bladder.

Abstract

Case Description—An 11-year-old Arabian gelding was evaluated for hematuria, stranguria, and pollakiuria that had been observed for 1 week.

Clinical Findings—Transrectal palpation revealed a 5-cm firm round mass in the urinary bladder. Cystoscopy and transrectal ultrasonography confirmed the diagnosis of urinary bladder urolithiasis.

Treatment and Outcome—A multiportal transparalumbar fossa laparoscopic approach was selected for cystotomy and urolith removal. Cystotomy and urolith removal was performed with sedation and local anesthesia with the horse standing. No perioperative complications were observed. Urination returned to normal 5 days after surgery. The horse returned to its previous level of activity at 3 weeks after surgery.

Clinical Relevance—Findings suggested that minimally invasive transparalumbar fossa laparoscopic approach can be successfully used for cystotomy and urolith extraction in standing horses; this avoids the disadvantages of conventional laparocystotomy for removal of large uroliths in male equids and the potential complications of general anesthesia and recovery. The technique provided excellent viewing and access to the bladder, permitting extraction of the urolith and secure closure of the cystotomy with minimal tension and tissue trauma to the bladder.

Contributor Notes

The authors thank Dr. Mustafa Elarbi for medical illustrations.

Address correspondence to Dr. Lund (lundcaleb@gmail.com).