Surgical treatment of retroiliac ectopic ureters with secondary hydronephrosis and hydroureter in a dog

Abstract

CASE DESCRIPTION An 8-month-old 41.2-kg (90.6-lb) sexually intact male Dogue de Bordeaux with urinary incontinence and signs of nausea was referred for further evaluation and treatment of bilateral hydronephrosis, hydroureter, and ectopic ureters. CLINICAL FINDINGS Clinicopathologic analyses revealed urine specific gravity and serum concentrations of urea nitrogen and creatinine within reference limits. Abdominal ultrasonography and CT revealed unilateral abdominal cryptorchidism, ureters that bilaterally passed dorsal to and appeared compressed by the external iliac arteries (retroiliac ureters), and bilateral hydronephrosis, hydroureter, and ectopic ureters. On CT, minimal uptake of contrast medium by the right kidney indicated either a lack of renal function or ureteral obstruction. TREATMENT AND OUTCOME The dog underwent exploratory laparotomy, right ureteronephrectomy, left neoureterocystostomy, bilateral castration, and incisional gastropexy without complication and was discharged 2 days postoperatively. Eleven days after surgery, the dog had improved but continued urinary incontinence, improved left hydronephrosis and hydroureter, and serum concentrations of urea nitrogen and creatinine within reference limits. At 24 months after surgery, the dog was reportedly clinically normal, other than having persistent urinary incontinence. CLINICAL RELEVANCE To our knowledge, this was the first report of a dog with retroiliac ureters and compression-induced ureteral obstruction with secondary hydroureter and hydronephrosis. Retroiliac ureters should be considered as a differential diagnosis in young dogs with ureteral obstruction. Our findings indicated that a good outcome was possible for a dog with retroiliac ureters treated surgically; however, the presence of additional congenital anomalies should be considered and may alter the prognosis in dogs with retroiliac ureters.

Outcome of selective mating in the Entlebucher Mountain Dog for reduction of ureteral ectopia

“…23 Ureterozele, Hydronephrose (HN) und Hydroureter (HU) sind assoziierte Befunde, aber auch Fehlbildungen wie renale Dysplasie, Kryptorchismus, vaginale oder urethrale Septen werden bei Hunden mit EU häufiger beobachtet. 16,20,22,32,40,45,72 Aufsteigende Harntraktinfektionen, 8,31,32,42,45 seltener HN und HU, 67 führen zu klinischen Beschwerden, bei fehlender medikamentöser und/oder chirurgischer Korrektur sogar zum Tod. 18 Operationsoptionen für intramurale EU sind Neoureterostomien 12,27,50,70 oder die urethroskopisch geführte Laserablation, 6,28,34,77 für extramural verlaufende EU die Ureterneozystotomie.…”