A minimally invasive surgical technique for ureteral ostioplasty in two fillies with ureteral ectopia.

The research article presents a case study where two young horses with urinary incontinence due to ureteral ectopia, a condition where the ureter opens in the wrong place, were successfully treated with a minimally invasive surgical technique known as ureteral ostioplasty.

Case Description and Clinical Findings

• The research subjects were two fillies, aged 3 months and 1 month, displaying urinary incontinence and urine scalding symptoms.
• The first horse underwent ultrasonography, which did not detect any kidney structural abnormalities. However, this horse was diagnosed with unilateral ureteral ectopia through cystoscopy.
• The second horse underwent CT scan, revealing bilateral nephropathy, significantly dilated ureters on both sides, and bilateral ureteral ectopia.
• Cystoscopy findings for both horses showed intramural ureteral ectopia with abnormally caudally positioned ureteral ostia.

Treatment and Outcome

• Both horses were treated with ureteral ostioplasty, a surgical procedure done under cystoscopic guidance to correct the misplaced ureters.
• In the first horse, laparoscopic scissors were used to cut the tissue separating the intramural part of the ureter from the bladder and urethra.
• In the second horse, a vessel-sealing device was used for the same purpose. In both cases, the tissue was cut in a cranial direction towards the trigone (an area at the base of the bladder).
• Following this minimally invasive surgical procedure, both fillies regained urinary continence and voided normal streams of urine. No relapse of incontinence was observed during a follow-up period of 20 months for the first horse and 9 months for the second.

Clinical Relevance

• The researchers concluded that cystoscopically guided ureteral ostioplasty is an effective and minimally invasive surgical treatment option for correcting ureteral ectopia. The successful outcomes in these two fillies validate this surgical method’s potential utility in similar cases.