Comparison of 3 techniques for ureteroneocystostomy in cats.
OBJECTIVE
To compare 3 techniques for ureteroneocystostomy in cats.


METHODS
Experimental surgical study.


METHODS
Fifteen adult cats.


METHODS
Cats (15) had ureteroneocystostomy with ureteronephrectomy of the contralateral kidney: 5 cats had an intravesical mucosal apposition technique (modified Leadbetter-Politano; intravesical-MA group), 5 cats had extravesical ureteroneocystostomy (modified Lich Gregoir) using a simple continuous suture pattern (extravesical-SC group) and 5 cats had an extravesical technique using a simple interrupted suture pattern (extravesical-SI group). Renal function was evaluated by measuring serum creatinine concentration. Ultrasonographic assessment of the kidney and ureteroneocystostomy site was performed the day after surgery, twice weekly for 3 weeks and once weekly for the remainder of the study. Cats were euthanatized 50 days after surgery. The kidney and ureter removed at surgery, the remaining kidney, ureter, ureteroneocystostomy site, and bladder were examined histologically.


RESULTS
Two extravesical-SC cats were euthanatized because of azotemia and uroabdomen, and 1 died acutely at day 4 for unknown reasons. In the intravesical-MA and extravesical-SI cats, the serum creatinine concentration increased after surgery, peaking at a mean (+/-SD) of 9.4+/-2.4 mg/dL and 4.9+/-3.3 mg/dL on day 3, and decreasing to 3.4+/-5.7 mg/dL and 1.5+/-0.4 mg/dL on day 7, respectively. The extravesical-SI technique was associated with consistently lower serum creatinine concentrations for the first week after surgery compared with the other techniques. The mean serum creatinine concentration was within the reference range in cats in the intravesical-MA and extravesical-SI groups by days 10 and 5, respectively. Renal pelvic dilatation occurred in all cats but resolved more rapidly in cats after extravesical techniques. There was no significant difference in serum creatinine concentrations or renal pelvic dilation between the intravesical-MA and extravesical-SI techniques. Bladder mass height at the anastomosis site was significantly larger and persisted for longer with intravesical-MA technique.


CONCLUSIONS
An extravesical-SI technique is seemingly the choice for ureteroneocystostomy in cats with undilated ureters. Renal pelvic dilation on ultrasound examination should be expected after ureteroneocystostomy in cats.


CONCLUSIONS
An extravesical ureteroneocystostomy technique using a simple interrupted pattern for anastomosis should be considered in cats undergoing renal transplantation.
Mehl
Margo L
ML
Veterinary Medical Teaching Hospital, the Department of Surgical and Radiological Sciences, and the Comparative Pathology Laboratory, University of California-Davis, Davis, CA 95616, USA. mmehl@ucdavis.edu
Kyles
Andrew E
AE
Pollard
Rachel
R
Jackson
Joshua
J
Kass
Philip H
PH
Griffey
Stephen M
SM
Gregory
Clare R
CR
D000818:Animals; D002415:Cats / Q000601:surgery*; D003559:Cystostomy / Q000379:methods / Q000662:veterinary*; D005260:Female; D007676:Kidney Failure, Chronic / Q000601:surgery / Q000662:veterinary; D016030:Kidney Transplantation / Q000379:methods / Q000662:veterinary; D011183:Postoperative Complications; D011897:Random Allocation; D016896:Treatment Outcome; D014513:Ureter / Q000601:surgery; D014519:Ureterostomy / Q000379:methods / Q000662:veterinary*; D014570:Urologic Diseases / Q000601:surgery / Q000662:veterinary; D013520:Urologic Surgical Procedures / Q000662:veterinary