Surgical management of a ureteral defect with ureterorrhaphy and of ureteritis with ureteroneocystostomy in a foal.

This research discusses a surgical intervention for a two-day-old male foal which developed uroperitoneum, a condition characterized by urine leakage into the peritoneal cavity. A ureteral defect and stenosis were diagnosed and subsequently treated through ureterorrhaphy and ureteroneocystostomy.

Study overview

• The study focuses on surgical responses to defects in the ureters, the tubes that transfer urine from the kidneys to the bladder, in a foal. Initial attempts were unsuccessful in locating the source of the uroperitoneum, a condition where urine leaks into the abdomen leading to discomfort and infection risk.
• Using bilateral nephropyelocentesis (a procedure to drain the urinary system) and antegrade urography (an imaging technique to inspect urinary tract), the researchers found a defect in the right ureter and narrowing (stenosis) of the left ureter.

Surgical procedures

• The defect in the right ureter was repaired using ureterorrhaphy, which involves suturing the wounded or ruptured part of the ureter. To aid this process, the foal was placed in dorsal recumbency in the Trendelenburg position, a posture that tilted the foal’s body with feet higher than the head.
• After ureterorrhaphy, the researchers used a ureteral catheter as a stent, basically a device to keep the ureter open and maintain its functionality.
• The stenotic (narrowed) left ureter was treated by transection, or cutting it, followed by ureteroneocystostomy. This involves surgically repositioning the ureter to directly drain into the bladder, bypassing the usual course.
• A technique known as the ‘drop-in mucosal apposition’ was used for the ureteroneocystostomy.

Post-operative results and conclusions

• The ureteral catheter was only removed 26 days post-surgery, indicating a relatively long recovery period for the foal.
• Histopathological inspection suggested that the left ureter’s stenosis may have been initiated by an inflammation (ureteritis) of unknown cause.
• The findings of the study suggest that the ‘drop-in’ method of ureteroneocystostomy can successfully be used for surgically modifying the ureters’ course in horses.
• Additionally, ureterorrhaphy along with a ureteral stent can effectively repair ureteral defects in foals.