Radical Cystectomy and Cutaneous Ureterostomy in 4 Dogs with Trigonal Transitional Cell Carcinoma: Description of Technique and Case Series

Abstract

Radical cystectomy with cutaneous ureterostomy is a viable salvage procedure for urinary diversion after cystectomy in dogs with invasive bladder neoplasia. Postoperative management and quality of life were considered acceptable by most owners. Future studies are warranted to evaluate survival time in a larger number of animals.

Radical cystectomy and subsequent ureterohysterostomy in a bitch

“…Ureteral implantation with neoanastomosis is required when radical cystectomy is performed. Various sites of anastomosis of the ureters have been previously described in the veterinary literature, including the skin, colon, and prepuce in the male dog or vagina in the female . The risk for ascending urinary tract infection (UTI) is high after anastomosis to the colon .…”

“…The risk for ascending urinary tract infection (UTI) is high after anastomosis to the colon . Cutaneous ureterostomy can be used only in animals tolerant to frequent local care and involves the owner's compliance . A high risk of ascending infections is described in man (73% complication rate) .…”

“…All surgical techniques described allowing radical cystectomy and subsequent ureteral anastomosis are associated with permanent urinary incontinence and a high risk of postoperative complication . These risks must be discussed preemptively with the animal's owner.…”

“…Radical cystectomy with pelvic lymph node excision is the gold standard of care in the management of invasive bladder cancer with trigone involvement in humans . It allows total tumor resection, removes the source of pain or discomfort secondary to the tumor and the local inflammation, reduces risk of recurrence or metastatic spread of the cancer, and prevents future urinary tract obstruction . Radical cystectomy involves excision of the entire bladder including the trigone and requires performing ureteral anastomosis to the body wall or to a structure allowing for external urine outflow.…”

“…Radical cystectomy involves excision of the entire bladder including the trigone and requires performing ureteral anastomosis to the body wall or to a structure allowing for external urine outflow. Urinary diversion to the skin, digestive tract, urethra, prepuce, or vagina has been reported in veterinary literature . It is uncommonly performed in animals because of the relatively high rate of complications associated with ureteral reimplantation and because few owners accept managing the resulting permanent urinary incontinence .…”