Preputial ureterostomy and uteroureterostomy for total cystectomy in 3 dogs

Abstract

Three client-owned dogs presented with dysuria and stranguria. Prostatic and bladder trigone neoplasms were diagnosed, and these patients also exhibited flat ribbon-like stools. One patient had previously undergone cutaneous ureterostomy after radical cystectomy but experienced recurrent ostia stenosis and severe uremic dermatopathy. Ureterostomy was performed as a salvage procedure, diverting urine to either the uterine stump or the prepuce. The patients recovered well, resulting in an improved quality of life. Unfortunately, one patient died during the immediate postoperative period due to pulmonary metastasis. The uterine stump is considered a better option for ureterostomy as it provides a greater barrier against ascending infections compared to ureteral anastomosis in the vagina, theoretically. These modified ureteral anastomoses offer a viable urinary diversion for patients undergoing complete cystectomy, maintaining an anatomic route for urination. The procedure of modified preputial ureterostomy, without the performance of penectomy, reduces postoperative morbidity and provides increased protection for the ostia. This study aims to describe a modified technique for ureterostomy following total cystectomy in dogs, diverting ureters either to the prepuce or the uterine stump, while preserving the original voiding ostium.