The Soft Tissue Surgery service at Anderson Moores is now able to offer minimally invasive treatment for incontinent female dogs with ectopic ureters.
The procedure is performed with a combination of cystoscopic and fluoroscopic guidance, which avoids open surgery in most patients while achieving a comparable success rate.
The procedure is performed with a rigid cystoscope. The opening of the ectopic ureter is identified. A guide wire followed by a ureteral catheter are guided in the abnormal ureter under cystoscopic visualisation (Fig.1). Contrast is then injected to perform a combined ureterogram (Fig.2) and retrograde urethrogram. This confirms the intra-mural location of the ectopic ureter with intra-operative fluoroscopy. The opening of the ureter is then re-positioned at the level of the trigone with the use of cystoscopic scissors or diode laser.
The procedure is not suitable for treatment of patients with extramural ectopic ureters; however, extra-mural ectopic ureters are extremely rare in dogs, meaning that the vast majority of female dogs with ectopic ureters are perfect candidates for minimally invasive treatment. Minimally invasive treatment of male dogs with ectopic ureters can be considered, although it requires a small perineal surgical approach to gain access to the pelvic urethra. Most patients will be ready to go home 12-24 hours after the procedure.
Fig. 1 A ureteral catheter is introduced in the ectopic ureter under cystoscopic guidance