Urinary tract SX Flashcards
What is the unidirectional flow of urine:
kidney-pelvis- ureter- ureterovesicular junction- bladder- urethra- os/ opening
Bladder:
- Blood supply
- Nerves
- Ligaments
Blood supply: Cd vesicular a. (some animals may also have a cr counterpart)
Nerves: Pudendal n. (somatic), hypogastric n. (sym), pelvis n. (para)
Ligaments: Lat ligaments, ventral ligament
What bladder ligament should you not transect & why?
Lateral ligament
location of blood supply, ureter & nerves
What bladder surface should be cut during a cystotomy?
Cut into ventral surface, NOT dorsal surface bc ureters and ductus deferens insert dorsally at trigone
What is the holding layer for the bladder?
Submucosa is the holding layer
Why aren’t nephrotomys performed often?
remove kidney stones, but it causes a loss of function.
What does a nephrostomy tube do?
reroute urine to bypass ureter
What is a subcutaneous ureteral bypass?
salvage technique that is a permanent ureter bypass
What procedure is done to reinsert ureter into bladder (i.e. ectopic ureter)?
neoureterostomy
What surgical approach is taken for bladder or urethra surgery?
Caudal midline celiotomy
What is a cystostomy?
Diversion of urine to bypass urethra. ( done if cant be unobstructed)
How much of the bladder can be removed in a cystoectomy?
60-75%
Why is a cystotomy preferred over a urethrotomy?
Incisions are easier- less prone to strictures
When is a urethrostomy indicated?
When stone formation cant be prevented
- remeber close skin to urethral mucosa and to make the site big!
What type of urethrostomy occurs in dog?
Prescrotal +/- penile amputation
- SU
What type of urethrostomy occurs in cats?
Perineal + penile amputation
- PU
Urethral prolapse sx
Urethropexy
How do you prevent urine contamination with cystotomy?
Make sure to use lap sponges to prevent urine contamination.
Stay sutures at apex of bladder and either side of the incision.
What does dilution is the solution to pollution mean?
Lavage using saline
- no additive because chemicals can cause further inflammation
- 50-100 mL/kg
- suctioned until fluid clear
Preferred drainage method is:
Either open or closed, but closed involves Jackson pratt or active suction
What are the benefits to feeding patient vs fasting- post op?
Improves incisional healing and decreases hospital stay
Feeding tube options
NG tube ( 2-3 days)
esophageal (3-4wk)
Gastrotomy (2 mo- placed on left side/ fundus)
