Laparoscopic removal of a bladder urolith in a standing horse.

The paper features a successful case of a non-invasive laparoscopic surgery to remove a bladder stone in a standing horse, under local anesthesia, which avoided potential risks from conventional surgery and general anesthesia.

Background

• An 11-year-old Arabian gelding was suffering from hematuria (blood in urine), stranguria (painful and slow urination), and pollakiuria (frequent urination) which persisted for a week.
• Through transrectal palpation, a firm mass of 5 cm was detected in the urinary bladder of the horse. Further diagnosis using cystoscopy (viewing the urinary tract) and transrectal ultrasonography confirmed that this was a urinary bladder stone, or urolith.

Methodology

• The team chose to use a multiportal transparalumbar fossa laparoscopic approach, a minimally invasive surgical procedure that is performed through several small incisions.
• This specific type of surgery, a cystotomy (surgical opening of the bladder) and urolith removal, was carried out while the horse was standing and under the influence of local anesthesia and sedation, rather than general anesthesia.

Outcome

• The surgery did not encounter any perioperative complications. The horse’s urination returned to normal 5 days post-surgery.
• The horse was able to return to its previous level of physical activity three weeks after the surgical procedure.

Conclusions

• The findings suggested that minimally invasive transparalumbar fossa laparoscopic approach can be effectively used for cystotomy and urolith extraction in standing horses. This technique averts the disadvantages of traditional laparocystotomy (a larger and more invasive surgery) usually employed for the removal of large uroliths in male horses.
• The approach also eliminates the potential complications that can occur from general anesthesia and recovery.
• Furthermore, the technique provided excellent viewing and access to the horse’s bladder, which allowed for the extraction of the urolith and secure closure of the cystotomy with minimal tension exerted and trauma caused to the bladder tissue.