The patient had an uneventful recovery, urinated normally after the procedure, and was discharged from the hospital the next
day. Cephalexin and butorphanol were prescribed. The owner was instructed to allow the dog normal activity and frequent opportunities
to urinate, to follow the normal feeding regimen, and to provide normal access to water.
Figure 5. The cut free wall or septum in the urethra showing the opened lumen of the ureter (A = ureteral mucosa) as one continuous
lumen with the urethra.
Follow-up examinations at two weeks and at two months after the procedure confirmed the complete resolution of the incontinence
and revealed normal urinalysis results. A phone report a year after the procedure indicated that the dog had minimal intermittent
incontinence, which started after an ovariohysterectomy was performed; the incontinence was well-controlled with phenylpropanolamine
(30 mg orally b.i.d.).
The advantages of transurethral cystoscopic ectopic ureter correction using a diode laser are that it can be performed at
the same time as the diagnostic transurethral cystoscopy, that it takes only about five minutes, and that it is minimally
invasive with minimal tissue trauma. And if resolution of incontinence is achieved, open ectopic ureter surgery is avoided.
Figure 6. The new right ureteral stoma for the ectopic ureter in the bladder (A = bladder lumen).
The disadvantages and complications of this technique have not been defined but potentially include the expense of the equipment,
an inability to correct all types of ectopic ureters, penetration of the urethral or bladder walls with the laser, and stricture
formation at the new stoma site.
Five other patients with ectopic ureters corrected with this technique have also had marked improvement in incontinence, which
is controlled with medication.1 However, more cases are needed to define case selection criteria and rate of success and to refine the operative technique.
"Endoscopy Brief" was contributed by Timothy C. McCarthy, DVM, PhD, DACVS, Surgical Specialty Clinic for Animals, 4525 S.W.
109th Ave., Beaverton, OR 97005.
Timothy C. McCarthy
1. Rawlings C, University of Georgia, Athens, Ga: Personal communication, 2006.