Penile urethral anastomosis to the vesico-urethral junction, after transabdominal wall passage of the penis, as treatment for intrapelvic stent-related urethral obstruction in a dog

Abstract

Objective: The objective of the present study was to report the outcome of anovel technique of urethral intra-abdominal anastomosis after transabdominalwall passage of the penis in a dog with stent-related urethral obstruction.Study design: Case report.Animal: A seven-year-old neutered male Cocker Spaniel.Methods: The dog was evaluated for urinary retention and overflow inconti-nence of approximately 1-year duration. The dog had a urethral self-expandingmetallic stent placed 6 years prior as treatment for pelvic urethral stricture,secondary to severe pelvic trauma. Stent fracture and stent-related tissuehyperplasia were diagnosed leading to intrapelvic urethral obstruction andconcomitant atonic bladder complicated by cystolithiasis and urinary tractinfection. An intra-abdominal urethral anastomosis was performed to restoreurethral patency, after passing the penis through the abdominal wall, into theinguinal area; the surgery was successful in bypassing the urethral obstruction.Results: No contrast leakage was noted on positive contrast cystourethrogra-phy 10 days postoperatively. The urinary bladder was easily emptied by man-ual expression and bethanechol was started. At 6-months follow-up, theurinary bladder remained atonic but was easily emptied by manual expression,with mild urinary incontinence remaining. No signs of recurrent urinary tractinfections were noted. Nine months after surgery the dog was euthanized forreasons unrelated to the surgery. Conclusion: The transabdominal wall urethral anastomosis, after penileabdominal tunnelization resulted in bypassing the urethral obstruction in thisdog, restoring urethral patency. The technique reported could be a viable sur-gical option for restoring urethral patency in dogs with severe pelvic urethraldamage or obstructive lesions