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Small Animal Surgery > Ureter > Flashcards

Ureter Flashcards

1
Q

What is ectopic ureter?

A

failure of one or both ureters to terminate in the normal location

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2
Q

What is the typical signalment for ectopic ureter?

A
  • Huskies, Labs, Goldens, Westies
  • rare in cats
  • females
  • young patients
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3
Q

What are the clinical signs associated with ectopic ureter?

A
  • incontinence
  • failure to house train
  • UTI
  • urine scalding
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4
Q

How is ectopic ureter diagnosed?

A
  • excretory urography
  • CT
  • ultrasound
  • cystoscopy
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5
Q

Describe an extramural ectopic ureter

A
  • enters and exits in the wrong location

- less common

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6
Q

Describe an intramural ectopic ureter

A
  • enters normally, but exits abnormally
  • transverses across the bladder wall
  • most common in dogs
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7
Q

How are ectopic ureters treated?

A
  • neoureterocystotomy (side to side, and end to side)

- laser transection of wall between ectopic ureter and bladder or urethra

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8
Q

Describe end to side neoureterocystotomy

A
  • re-implantation of ureter for extramural EU
  • transect ureter where it enters the bladder, ligate, and place stay suture at the end
  • stab incision into bladder
  • pull suture through bladder wall and secure ureter
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9
Q

Describe side to side neoureterocystotomy

A
  • intravesicular diversion for intramural EU
  • perform cystotomy
  • occlude abnormal ureter exit and watch for urine buildup
  • make slit in that area
  • suture ureter to that location
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10
Q

Describe laser transection of wall between EU and bladder/urethra

A
  • find where abnormal ureter exits the bladder

- obliterate wall between ureter and bladder up to normal location

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11
Q

What is the prognosis for ectopic ureter?

A
  • other functional abnormalities may still exist
  • incontinence improves in 60%
  • 90% improvement with medication
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12
Q

What is a ureterocele?

A

dilation of distal ureter

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13
Q

What are the two classifications of ureteroceles?

A
  • intravesicular (in normal location)

- ectopic

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14
Q

What are the clinical signs associated with ureteroceles?

A
  • UTI
  • incontinence
  • azotemia if obstruction
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15
Q

How is a ureterocele diagnosed?

A
  • IV urography (cobra head sign)

- ultrasound

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16
Q

How are ureteroceles treated?

A
  • intravesicular: ureterocelectomy

- ectopic: neoureterocystotomy with ureterocelectomy

17
Q

What are the causes of ureteral trauma?

A
  • iatrogenic is #1 (clamp injury)
  • blunt trauma
  • obstruction
18
Q

How is ureteral trauma diagnosed?

A
  • uroretroperitoneum
  • uroabdomen
  • radiographs
  • IV urography
19
Q

What are the treatment options for ureteral trauma?

A
  • nephroureterectomy
  • ureteroureterostomy
  • neoureterocystotomy
  • urinary diversion
20
Q

What are the two methods of urinary diversion?

A
  • ureteral stent

- nephrostomy tube

21
Q

What treatment is used when the proximal ureteral length is insufficient to reach the bladder?

A

transureteroureterostomy

22
Q

Describe renal descensus

A

mobilize the kidney and suture caudally to the musculature

23
Q

Describe nephrocystopexy

A
  • dissect kidney out of fossa

- suture kidney to the cranial edge of the bladder

24
Q

When is a bladder wall flap performed?

Describe it

A
  • significant loss of distal ureter
  • elevated bladder flap
  • implant ureter to end of flap
  • suture flap in a tube and close the defect
25
Q

What are the clinical signs associated with ureterolithiasis?

A
  • can be asymptomatic
  • UTI, hematuria
  • anorexia, lethargy, pain
26
Q

What is the medical management for ureterolithiasis?

A
  • dissolution is not an option for Ca oxalate
  • IV fluids and diuretics
  • smooth muscle relaxants
27
Q

What are the indications for surgical treatment of ureterolithiasis?

A
  • complete obstruction
  • azotemia
  • pyelonephritis
  • medical failure
28
Q

What are the surgical treatment options for ureterolithiasis?

A
  • cystotomy, retrograde flushing, and removal via pyelithotomy
  • ureterotomy
  • permanent ureteral stenting
29
Q

What are the advantages of permanent ureteral stenting?

A
  • decreases morbidity
  • shorter hospitalization
  • less complications
30
Q

What are the indications for permanent ureteral stenting?

A
  • stone
  • tumor
  • stricture
  • blood clot
31
Q

What are the different ureteral stent techniques?

A
  • endoscopic
  • surgical
  • subcutaneous ureteral bypass

Small Animal Surgery (26 decks)

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