Transurethral endoscopic‐guided intraluminal closure of multiple urinary bladder tears in a standing mare

Abstract

Summary This case report is the first published description of a minimally invasive transurethral endoscopic‐guided approach to repair multiple bladder tears in a standing mare. The mare was diagnosed with a ruptured bladder 48 h post‐partum based on clinical signs, transabdominal ultrasonography, serum and peritoneal fluid analysis, and cystoscopy. Under sedation and epidural anaesthesia and with cystoscopic visualisation, two bladder tears were sutured using an articulating endoscopic suturing device. The device was placed transurethrally and a simple continuous pattern of 2‐0 braided lactomer used to close two full‐thickness tears. The surgery time was 50 min and no complications were encountered. Cystoscopy 60 days post‐operatively confirmed complete healing of the tears and no evidence of urolithiasis.

Conservative management of iatrogenic bladder rupture and uroperitoneum in a gelding with urolithiasis

“…2016; Pye et al . 2018); however, the present report suggests that healing may not always be protracted with medical therapy and the costs of medical management may be lower than the costs associated with surgical repair.…”

“…2012) or the urethra (Pye et al . 2018) has been reported but is only possible in mares. In this gelding in the current report, the bladder tear was located in the ventral body of the bladder, a location that is extremely difficult to access surgically (Ragle 2008; Higuchi et al .…”

“…There is therefore an understandable tendency towards closing the tear in the bladder as soon as it is identified in order to prevent further contamination of the abdomen with urine (Snalune and Mair 2006; Schott and Woodie 2012; Pye et al . 2018). However, surgical access to the bladder via laparotomy is limited, and hydro‐distention which is reported to improve access is not possible where the bladder is torn (Russell and Pollock 2012).…”

“…2016); however, surgical repair of bladder tears is advocated (Schott and Woodie 2012; Snalune and Mair 2006) to reduce uroperitoneum which is associated with potentially fatal chemical and septic peritonitis and electrolyte imbalances (Pye et al . 2018). Walesby et al .…”

Management of bladder rupture in mature horses

“…Surgical repair is recommended when possible (Schott and Woodie 2012; Pye et al . 2018). In some cases, the location of the tear may preclude surgical access and conservative management with secondary intention healing is chosen.…”