Partial cystectomy and bilateral ureteroneocystostomy for resection of invasive transitional cell carcinoma involving the trigone area of the bladder in a dog - case report

Abstract

This study aims to report the technique of partial cystectomy and bilateral ureteral reimplantation for resection of transitional cell carcinoma (TCC) in the trigone region of the bladder and the long-term follow-up in a Bernesse Mountain dog. The proposed surgical technique was considered viable and a potential treatment option for TCC in bladder trigone, with benefits regarding the prevention of urinary tract obstruction due to neoplastic growth and local removal of the primary tumor, which may limit or delay the spread of the disease even without adjuvant chemotherapy. The main disadvantages related to the described technique are ureteral stricture, intermittent cystitis and local relapse. However, the results are acceptable considering the long-term survival of 610 days in the case described.

Study on various affections of lower urinary tract in dogs

“…to the present findings, intermittent haematuria reported in nine year old Bernese Mountain dog had metastasis of transitional cell carcinoma of urinary bladder [15] . Other recorded symptoms in the present study are in agreement with findings of Nandini et al (2016) [11] and Shaharan et al…”

A Systematic Review of Canine Cystectomy: Indications, Techniques, and Outcomes

“…These discrete lesions are generally located distant from the trigone of the bladder at the apex, craniodorsal wall, or cranioventral wall [ 14 , 24 , 25 , 28 , 29 , 31 ]. However, in several studies, partial cystectomies have been performed for tumors located in the trigone and neck of the bladder involving the proximal urethra or the ureterovesicular junctions [ 15 , 23 , 24 , 25 , 30 , 33 ]. For these cases in which the communications between bladder and urethra/ureters were preserved, surgical margins were generally not wide relative to the tumor due to proximity of the trigone and associated structures.…”

“…For these cases in which the communications between bladder and urethra/ureters were preserved, surgical margins were generally not wide relative to the tumor due to proximity of the trigone and associated structures. However, if wide excision is pursued for tumors in these locations, or if resection of all gross disease inherently involves the ureterovesicular junction(s) or urethra, additional procedures such as neoureterocystostomy and/or bladder-urethral anastomosis become necessary [ 15 , 23 , 24 , 25 , 33 ]. It is important to also consider the potential for compromise of the neurovascular supply (particularly the caudal vesical artery and pelvic plexus, comprising somatic, parasympathetic, and sympathetic innervation) to the bladder, which enters dorsally at the bladder neck near the trigone.…”

“…The largest study to date on dogs that underwent partial cystectomy for treatment of UC included 5/37 dogs that had partial thickness excisions in the region of the trigone, and 2/37 dogs that required neoureterocystostomies due to trigonal involvement [ 25 ]. An additional case report of partial cystectomy involving the trigone of the bladder described a full thickness 40–50% partial cystectomy with resection of the bilateral ureterovesicular junctions and subsequent bilateral neoureterocystostomies [ 33 ].…”

“…The majority of dogs survive to discharge, with deaths in the postoperative period predominantly unrelated to surgery or anesthetic complications [ 14 , 23 , 24 , 25 ]. Potential complications associated with partial cystectomy include ureteral/urethral obstruction secondary to blood clots, stricture and/or tumor recurrence, uroabdomen, bladder necrosis, incisional complications, disease progression/recurrence, and neoplastic seeding of the abdomen/abdominal wall [ 23 , 25 , 30 , 33 , 34 , 38 , 49 ]. Pollakiuria, stranguria, and hematuria are common transient postoperative findings [ 23 , 25 ].…”