bladder surgery

Question 1

what contains the ureter?

Answer 1

lateral ligament

Question 2

what does the ventral ligament contain?

Answer 2

the urachus

Question 3

which ligament can be cut during surgery and not have any negative effects?

Answer 3

the ventral ligament because it only contains the urachus which is not important once no longer a fetus

Question 4

what are some urachal abnormalities ?

Answer 4

• persistent urachus
• vesico-uracheal diverticulum
• urachal cyst
• urachal sinus

Question 5

true or false.

severity of emergency in cases of bladder rupture depend on how it was acquired.

Answer 5

false! ALWAYS emergency

Question 6

how do we diagnose bladder rupture?

Answer 6

• positive contrast urethrocystogram - most reliable
• radiographs
• ultrasound

Question 7

what is the indication for a tube cystostomy ?

Answer 7

the need for urinary diversion, ex. - when unable to catherterize in LUT obstruction or bladder trauma surgery

Question 8

what are the complications of tube cystostomy ?

Answer 8

• accidental tube removal
• breakage of mushroom tip
• fistula
• urine leaking around tube

Question 9

when is a cystopexy indicated ?

Answer 9

• tube cystostomy
• perineal hernia
• urinary incontinence associated with pelvic bladder

Question 10

how is a cystopexy performed?

Answer 10

attach the bladder wall to the abdominal wall with two lines of sutures

Question 11

what are the most common types of cystic calculi ?

Answer 11

• struvite - most common
• calcium oxalate
• urate
• cystine

Question 12

what are the clinical signs of cystic calculi ?

Answer 12

similar to LUTD, large bladder, may be able to feel large calculi, UTI common

Question 13

how do you diagnose cystic calculi?

Answer 13

• pneumocystography
• double contrast cystography
• radiographs
• ultrasound

Question 14

what are the non-surgical treatments for cystic calculi ?

Answer 14

• hydropropulsion
• transurethral cystoscopy
• dietary modification

Question 15

what is the surgical treatment for cystic calculi ?

Answer 15

cystotomy

Question 16

what approach should cystotomy use?

Answer 16

ventral approach

Question 17

what is important to remember when draping the patient for a cystotomy?

Answer 17

males need the prepuce draped in the field in case we need to access it

Question 18

what is the best way to handle tissue during a cystotomy?

Answer 18

stay sutures - less traumatic

Question 19

what type of suture should we use for cystotomy ?

Answer 19

PDS, monocryl, something absorbable

Question 20

what is polypoid cystitis ?

Answer 20

rare disease that affects mucosa and resembles TCC but is non-neoplastic

Question 21

how do you diagnose polypoid cystitis ?

Answer 21

• ultrasound
• cyctoscope
• biopsy

Question 22

how do you treat polypoid cystitis ?

Answer 22

surgery

Question 23

what is the most common bladder tumor of the dog?

Answer 23

transitional cell carcinoma

Question 24

what is the most common bladder tumor of the cat?

Answer 24

transitional cell carcinoma

Question 25

how does TCC differ in cats and dogs?

Answer 25

found mostly in the trigone in dogs and the apex in cats

Question 26

how do you treat TCC ?

Answer 26

• partial cystectomy

- salvage procedures like utererocolonic anastomosis or ureterouterine anastomosis

Question 27

how do you diagnose TCC?

Answer 27

• radiographs
• ultrasound
• transurethral biopsy
• BTAT

Question 28

what is a disadvantage of using BTAT to diagnose TCC?

Answer 28

high amount of false positives