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CVSOH BVSc4 > Urinary - surgery > Flashcards

Urinary - surgery Flashcards

1
Q

What are the 3 most common surgical renal diseases?

A

Neoplasia
Renal calculi
Hydronephrosis

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2
Q

What are the 3 most common renal surgery procedures?

A

Ureteronephrectomy
Renal biopsy
Nephrotomy

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3
Q

What are the methods of renal biopsy samples?

A

Ultrasound guided
Laparoscopic
Surgical
FNA/Tru-cut/incisional biopsy

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4
Q

What are the different types of renal neoplasia?

A

Lymphoma
Renal cell carcinoma
Transitional cell carcinoma

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5
Q

What is a ureteronephrectomy?

A

Removal of kidney and ureter (double ligated at bladder neck)

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6
Q

What is the most common renolith/renal calculi?

A

Calcium oxalate

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7
Q

How do you treat renoliths?

A

Nothing - often dont need treating
Surgery - nephrotomy (not really done tho)
If they are obstructive or causing UTI/haematuria

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8
Q

What are the most common ureteric surgical diseases?

A

Urethral trauma
Urethral calculi
Urethral neoplasia
Ectopic ureter

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9
Q

How do you treat ureteric calculi?

A

Diuresis
Lithotripsy
Surgery - subcutaneous ureteral bypass or ureteral stent

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10
Q

What is the prognosis of ureteral surgery?

A

High complication rate

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11
Q

What are the causes of hydronephrosis?

A

Pyelonephritis
Obstruction
Congenital stenosis

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12
Q

What is the treatment for hydronephrosis?

A

Ureteronephrectomy

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13
Q

What is the presentation of ectopic ureters?

A

Young dogs
PUPD
Urinary incontinence - dribbling
UTI common

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14
Q

What is the best diagnostic technique to diagnose ectopic ureter?

A

CT

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15
Q

What are the 2 types of ectopic ureter?

A

Intramural - runs submucosally in bladder wall before opening into urethra (more common)
Extramural - completely bypasses the bladder (less common, much harder to treat)

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16
Q

What are the different surgical treatments for ectopic ureter?

A

Lase ablation - for intramural in females
Neoureterostomy - for intramural in males
Ureteroneocystostomy - for extramural

17
Q

What are the 3 surgical bladder diseases?

A

Bladder calculi
Bladder rupture
Bladder neoplasia

18
Q

What are the different surgical procedures?

A

Bladder biopsy
Cystotomy
Cystectomy
Cystostomy
Cystopexy

19
Q

What is the only type of calculi that can be dissolved?

A

Struvite

20
Q

What is the main surgical treatment for cystoliths in first opinion?

A

Cystotomy

21
Q

How do you perform a simple cystotomy?

A

Caudal midline laparotomy
Exteriorise bladder and pack off the abdomen
Stay sutures into bladder apex
Stab incision
Remove calculi
Close bladder
Omentalise
Close abdomen
Radiograph

22
Q

What are the complications of cystotomy?

A

Residual calculi
Uroabdomen
Suture-associated calculogenesis
Haematuria/dysuria

23
Q

What is the main surgical disease of the urethra?

A

Canine/feline urethral obstruction

24
Q

What are the treatments for urethral obstruction?

A

Urethrostomy - make male pee through perineum/scrotum like female (for recurrent obstruction)
Retrohydropropulsion - to avoid urethral surgery

25
Q

How do you do retrohydropropulsion of the urethra?

A

Compress pelvic urethra (easier with two people)
Increase pressure through syringe to dilate urethra
Then release pressure to push stones back into bladder

26
Q

What is atonic bladder? How do you treat it?

A

Dysuria due to bladder muscle overdistension
Treat with detrusor stimulants and urethral relaxant
Avoid bladder filling for 4-6 weeks

27
Q

What is the most common type of bladder neoplasia?

A

Transitional cell carcinoma

28
Q

How can you treat bladder neoplasia?

A

Medical - chemo, NSAIDs
Surgery - for benign only
Surgical and medical - cystectomy, can be better survival
Palliative - diversion, stenting (stops blockage)

29
Q

What are the indications for cystectomy (can remove up to 70% of bladder)?

A

Polypoid cystitis - curative
Necrotic bladder
Early neoplastic lesions

30
Q

What is a tube cystostomy?

A

Diverts urine away from the urethra - down separate catheter out of body wall

31
Q

How do you do a tube cystostomy?

A

Do laparotomy
Foley catheter through stab incision in body wall adjacent to bladder
Purse string suture
Stab incision into bladder centre and foley catheter pushed through
Purse string suture
Suture bladder to body wall
Then close laparotomy incision
Foley catheter attached to external skin with tape and help in place with vest

32
Q

How can you diagnose urinary tract rupture?

A

Rising plasma urea creatinine levels on bloods
Or uroabdomen - level of urea creatinine compared to blood
Intravenous urethrogram - best for identifying ruptures of kidney and ureter

33
Q

How do you treat a bladder rupture?

A

Stabilise
Ex lap - methodical 4 quadrant check
Debride damaged bladder
Suture closed as for cystotomy
Omentalise
Flush abdomen - warm saline, suction

34
Q

How do you treat urethral rupture?

A

Repair - chance of stricture formation
Bypass urethra - tube cystostomy, indwelling urethral catheter

35
Q

What is a cystopexy?

A

Secure bladder to abdominal wall - stop herneation

CVSOH BVSc4 (86 decks)

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