Removal of lower urinary tract stones by percutaneous cystolithotomy: 68 cases (2012–2017)

Abstract

Objective To describe the use and outcome of percutaneous cystolithotomy (PCCL) for removal of urethral and bladder stones in dogs and cats. Study design Retrospective case series. Animals Sixty‐eight client‐owned dogs and cats. Methods Records were reviewed and analyzed for dogs and cats that underwent PCCL between January 2012 and December 2017. Signalment, clinical presentation, laboratory and imaging data, procedure time, use of lithotripsy, biopsy, perioperative and immediate postoperative complications, hospitalization times, stone composition, and urine culture results were recorded. Owners were contacted by phone or email 3 weeks after the procedure. Follow‐up communications with the owner and referring veterinarian were also recorded. Results Seventy percutaneous cystolithotomies were performed in 59 dogs and nine cats. The median duration of the procedure was 95 minutes (45‐420), and lithotripsy was required in 3% (2/70) of PCCL. Complications during the procedure were reported in one case. In eighty‐three percent of procedures (58/70), animals were discharged within 24 hours postoperative. Twenty‐four percent (16/68) of animals had minor complications (lower urinary tract signs), and one dog had a major complication (surgical wound dehiscence) during the 3 weeks after the operation. Long‐term follow‐up revealed stone recurrence in 21% of cases followed more than a year after the procedure (7/33). Conclusion Percutaneous cystolithotomy allowed removal of bladder and urethral stones with rapid postoperative recovery and few major perioperative or short‐term postoperative complications. Clinical significance Percutaneous cystolithotomy provides an attractive minimally invasive surgical alternative for removal of lower urinary tract stones in small animals.

Feline urinary incontinence: a retrospective case series (2009–2019)

“…Antegrade cystoscopy through a percutaneous approach could be performed in male cats as an alternative. 34 In one cat, retrograde catheterization was not possible because of a stricture at the perineal urethrostomy site. Fluoroscopically guided percutaneous antegrade urethral catheterization could have been performed in this patient to inject contrast and gain urethral access as an alternative method to confirm the diagnosis.…”

Retrospective comparison of open vs minimally invasive cystotomy in 28 cats using a composite outcome score

“…This inherent anatomic challenge emphasizes the necessity for postoperative imaging. Previous reports document incomplete removal of uroliths in up to 20% patients, [2][3][4][5][6][7] but since postoperative radiographs are not always performed, the true incidence is unknown. Imaging modalities such as abdominal ultrasound or contrast cystourethrography could also be considered postoperatively to ensure complete urolith removal.…”

“…Long-term recurrence or pseudo-recurrence (calculi left behind previously) of cystic calculi was not included in this study, but has been reported in approximately 13-21% of patients. [4][5][6] The last variable considered was postoperative complications. Five of six cats with reported postoperative complications were from the open group, but this difference did not reach statistical significance.…”

“…An increased cost associated with laparoscopic procedures in veterinary medicine has been reported previously. 3,5 Usually, increased costs stem from equipment costs or longer anesthesia times. Interestingly, in human medicine laparoscopy often saves patients money owing to their earlier release from hospital and reduced need for intensive care.…”

“…[8][9][10][11] Both dogs and cats may benefit from minimally invasive procedures; however, reports of outcomes solely in feline patients are under-represented in the literature. [12][13][14][15][16] While laparoscopic-assisted cystotomy (LAC) and percutaneous cystolithotomy (PCCL) techniques have been described in cats for treatment of cystic calculi in several studies, [4][5][6] they made up <30% of the study populations.…”