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.

OBJECTIVE

The objective of the present study was to report the outcome of a novel technique of urethral intra-abdominal anastomosis after transabdominal wall 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 incontinence of approximately 1-year duration. The dog had a urethral self-expanding metallic stent placed 6 years prior as treatment for pelvic urethral stricture, secondary to severe pelvic trauma. Stent fracture and stent-related tissue hyperplasia were diagnosed leading to intrapelvic urethral obstruction and concomitant atonic bladder complicated by cystolithiasis and urinary tract infection. An intra-abdominal urethral anastomosis was performed to restore urethral patency, after passing the penis through the abdominal wall, into the inguinal area; the surgery was successful in bypassing the urethral obstruction.

RESULTS

No contrast leakage was noted on positive contrast cystourethrography 10 days postoperatively. The urinary bladder was easily emptied by manual expression and bethanechol was started. At 6-months follow-up, the urinary bladder remained atonic but was easily emptied by manual expression, with mild urinary incontinence remaining. No signs of recurrent urinary tract infections were noted. Nine months after surgery the dog was euthanized for reasons unrelated to the surgery.

CONCLUSION

The transabdominal wall urethral anastomosis, after penile abdominal tunnelization resulted in bypassing the urethral obstruction in this dog, restoring urethral patency. The technique reported could be a viable surgical option for restoring urethral patency in dogs with severe pelvic urethral damage or obstructive lesions.