Urinary Tract

A Systematic Review of Canine Cystectomy: Indications, Techniques, and Outcomes

“…An alternative consideration for partial cystectomy involves partial thickness excisions of bladder tumors. This is mainly indicated for benign mucosal lesions, as in dogs with multiple polyps throughout the bladder resulting in clinical signs [ 38 ]. Though partial thickness resection can be considered for cytoreductive palliation of UC causing urinary obstruction, this is often not feasible without leaving residual gross disease owing to the invasive nature of these tumors.…”

“…For a standard cystectomy, fine-gauge monofilament stay sutures are placed near the planned cystectomy incision to facilitate bladder handling and manipulation. An initial bladder incision is made with a blade in a location along the planned partial cystectomy site, ideally based on margins of 1–3 cm (depending on the location and size of the tumor as well as the size of the bladder) for wide excision from the gross disease [ 38 ]. The incision is then extended with scissors to allow for evaluation of the bladder mucosa and completion of the cystectomy.…”

“…The incision is then extended with scissors to allow for evaluation of the bladder mucosa and completion of the cystectomy. If the planned surgical margin encroaches on the ureterovesicular junction(s), decision making requires either sacrificing margins to preserve the junction(s) or excising the ureteric orifice with subsequent reimplantation of the ureter(s) [ 15 , 23 , 38 ]. If the ureterovesicular junction is excised, a margin of at least 2 cm of ureter is generally excised concurrently in an effort to achieve histologically tumor-free margins [ 15 , 38 ].…”

“…If the planned surgical margin encroaches on the ureterovesicular junction(s), decision making requires either sacrificing margins to preserve the junction(s) or excising the ureteric orifice with subsequent reimplantation of the ureter(s) [ 15 , 23 , 38 ]. If the ureterovesicular junction is excised, a margin of at least 2 cm of ureter is generally excised concurrently in an effort to achieve histologically tumor-free margins [ 15 , 38 ]. Following partial cystectomy, bladder wall closure is routine via a one- or two-layer appositional closure with a simple interrupted or simple continuous pattern using fine-gauge, absorbable, monofilament suture material.…”

“…Although some reports document placement of an indwelling urinary catheter at the time of surgery to keep the bladder decompressed during early healing, the need for this is controversial and indwelling catheter placement is often not indicated/required [ 14 , 23 , 31 ]. Following closure of the urinary bladder, lavage should be performed to remove any blood clots and potential tumor cells, and gloves and instruments should be changed prior to routine abdominal closure in an effort to reduce the risk of seeding tumor cells [ 38 ]. Postoperatively, dogs are generally administered intravenous fluids at a maintenance rate to flush out blood clots and debris from the bladder [ 38 ].…”