Surgery of the urinary tract Flashcards
Define a cystotomy
Incision into the bladder
Define a nephrectomy
Removal of a kidney
Define a nephrotomy
Incision into the kidney
Define a urethrostomy
Permanent opening into the urethra
Define a urethorotomy
Incision into the urethra (temporary)
Define a ureteronephrectomy
Removal of the ureter and kidney
When might a cystotomy be done?
Removal of tumours
Removal of urinary calculi
Describe pre-opcare for a cystotomy
Blocked urethra = distend abdomen, post renal uraemia, hyperkalaemia
Hyperkalaemia can lead to cardiac arrhythmias, fluid and electrolyte imbalance
Uroabdomen sees uraemia, dehydration, hypovolaemia and hyperkalaemia. If not treated these animals will die
Mild to moderately dehydrated, 0.9% sodium chloride infused
Perioperative antibiotics
Describe intraoperative care for a cystotomy
IV fluids to correct hydration and maintain normovolaemia
ECG trace
Describe surgical prep for a cystotomy
Catheterization of the bladder may be initially requested
Preparation of the abdomen for a midline incision
Describe how a cystotomy takes place
The bladder is located and exteriorized, via a midline incision
The abdomen is packed off prior to the incision being made into the bladder wall
Stay sutures are placed to assist with handling the bladder. The incision into the bladder is made on the ventral surface
Removal of a Bladder stone etc
Bladder wall is closed using two layers of sutures
Abdominal Lavage may be indicated
Describe post operative care for a cystotomy
Monitoring of urination is essential –
Animals should be given ample opportunity to urinate to avoid pressure being put on the sutures
Intravenous fluids may be indicated
Monitor for signs of leakage from the bladder –
No case should be discharged without passing urine normally
