Enterocystoplasty with Cystectomy and Subtotal Intracapsular Prostatectomy in the Male Dog

Abstract

Urinary diversion by implantation of the ureters into an isolated segment of jejunum was evaluated in eight clinically normal male dogs. Total cystectomy and subtotal intracapsular prostatectomy were performed, and the intestinal loop was sutured to the prostatic remnant. General health, renal function, acid-base balance, urinary tract infection, and urinary continence were monitored during observation periods of 4 to 30 weeks. All dogs survived the observation period and seven were in excellent general health at the time of euthanasia. Six of the 16 ureterointestinal anastomoses were complicated by complete ureteral obstruction. Absorption of urea from the intestinal loop was speculated as the reason for significant increases in serum urea nitrogen concentrations in all of the dogs. Serum creatinine concentrations generally remained within the normal range, but were significantly increased from preoperative baseline values by week 30. There was dilation of 12 renal pelves and ureters in seven dogs. Urine bacterial cultures were positive in six dogs, but histologic evidence of pyelonephritis was present in only five kidneys. Ejaculation was not affected by the procedure, but epididymitis was present in five dogs. The dogs could urinate consciously and did not dribble urine continuously; however, they urinated hourly. While the procedure was well tolerated by the dogs, the frequency of urination makes this technique unacceptable for most household pets.

Avaliação clínica e histopatológica de alo-transplante de bexiga em cães

“…Esses procedimentos, conhecidos como anastomose do trígono vesical, utilizados no homem, estão sujeitos a complicações, principalmente pela natureza histológica diferente entre o enxerto e a bexiga. As mais observadas são as fístulas, urolitíases, ausência de dilatação, contração do enxerto, neoplasias (Lepper et al, 2002), produção de muco e problemas metabólicos provenientes da absorção pela mucosa do tecido implantado (Fries et al, 1991).…”

Radical cystectomy and subsequent ureterohysterostomy in a bitch

“…Ureteral implantation with neoanastomosis is required when radical cystectomy is performed. Various sites of anastomosis of the ureters have been previously described in the veterinary literature, including the skin, colon, and prepuce in the male dog or vagina in the female . The risk for ascending urinary tract infection (UTI) is high after anastomosis to the colon .…”

“…Radical cystectomy involves excision of the entire bladder including the trigone and requires performing ureteral anastomosis to the body wall or to a structure allowing for external urine outflow. Urinary diversion to the skin, digestive tract, urethra, prepuce, or vagina has been reported in veterinary literature . It is uncommonly performed in animals because of the relatively high rate of complications associated with ureteral reimplantation and because few owners accept managing the resulting permanent urinary incontinence .…”

Interventional Urology

“…Placement of surgical cystostomy tubes, debulking surgery, and surgical diversionary procedures are invasive and often associated with undesirable outcomes. [70][71][72][73][74] Placement of self-expanding metallic stents under fluoroscopic guidance via a transurethral approach can be a fast, reliable, and safe alternative to establish urethral patency regardless of the benign or malignant nature and is an outpatient procedure. [29][30][31][32] This technique has been performed in more than 100 canine and 15 feline patients in the author's practice (Fig.…”