Sx of ureters Flashcards
What is the breed, sex, age and CS of ectopic ureter?
Siberian Husky
Labrador/Golden Retriever
West Highland Terrier
Female canines
Young patients
Incontinence
Fails to house train
UTI
Urine scalding
How do you diagnose and classify ectopic ureter and what is the most common type?
Excretory urography
76% accurate
Pneumocystography
Fluoroscopy
CT
Ultrasound
Cystoscopy
Intramural - enters normally but exits abnormally
How do you treat ectopic ureter and what is the prognosis after treatment?
Neoureterocystostomy (end to side) (extramural)
Neoureterocystostomy (side to side) (intramural)
Laser transection of wall between EU and
bladder or urethra (intramural)
Incontinence improves in 60%
90% improvement when add medications (PPA)
What are the two types of ureteroceles
what are the clinical signs
how do you diagnose it, and
how do you treat it?
Intravesicular (normal)
Ectopic (neck/urethra)
UTI, incontinence
Azotemia if obstruction
IV urography - Cobra head sign
Ultrasonography
Intravesicular:
Ureterocelectomy
Ectopic:
Neoureterocystostomy
with ureterocelectomy
What are the causes of ureteral trauma,
how do you diagnose it,
what are the criteria to determine treatment,
what are the treatment options, and what are the advantages/disadvantages of the different treatments
#1 cause iatrogenic!
Blunt trauma
Obstruction
Diagnosis
Uroretroperitoneum
Uroabdomen
Radiographs
IV urography - Localizes lesion
Based on time, location and severity
Nephroureterectomy - $ constraints, Minimizes complications
Ureteroureterostomy (ureteral anastomosis) - prox ureter damage, extremely difficult, high complication rate (strictures, dehiscence)
Neoureterocystostomy (ureteral
reimplantation)
Urinary diversion
What two methods are available for urinary diversion after ureteral surgery?
ureteral stent
nephrostomy tube
What procedures can be used if you have loss of length the of distal or proximal ureter
Transureteroureterostomy
Renal Descensus
Nephrocystopexy
Psoas Hitch
Bladder wall flap
What are the clinical signs of ureterolithiasis
how do you diagnose it,
what are the presurgical considerations and criteria for treatment, and what are the treatment options?
Asymptomatic,
UTI, hematuria
Anorexia, lethargy, pain
Radiographs - Most are radiopaque Ca oxalate
Ultrasound - Also determines dilation of ureter/pelvis
Cannot predict how long ureter obstructed
1 week obstruction GRF <65%
Cannot predict how well kidney will recover
Most cats have preexisting interstitial nephritis unrelated to obstruction
If azotemic with unilateral obstruction has bilateral renal disease
High complication rate with surgery
Cystotomy and retrograde flushing and removal via pyelithotomy
Ureterotomy
What are the advantages and disadvantages of ureteral stenting
what are the surgical and non-surgical methods of stenting?
Advantages:
Decreased morbidity, Shorter hospitalization, Less complications
Disadvantages:
Specialized equipment, Steep learning curve
Techniques:
Endoscopic
Surgically
The SUB
What is the SUB and describe how the ureter is bypassed?
Subcutaneous Ureteral Bypass
