A Novel Surgical Hybrid Approach to Neoplastic Lesions in the Distal Part of the Urethra: A Pilot Series of Clinical Cases

Abstract

All the surgical approaches described to date for the removal of distal urethral tumors have some technical difficulties that make these tumors difficult to treat. The article presents for the first time the treatment results of three female dogs, diagnosed with transitional cell carcinomas of the distal urethra, operated with a newly developed hybrid surgical method-a combination of laparoscopy and open surgery. This technique uses vulvovaginectomy, combined with resection of the distal urethra and prepubic urethrostomy. All of the procedures were possible to perform, without the need to carry out a laparotomy conversion. Histopathology revealed transitional cell carcinoma in all cases, with a margin of healthy tissues maintained in two out of three cases, which meant reoperation of the urethrostomy site in the remaining one case. The mean survival time was nine months. Among minor complications, recurrent cystitis was found. After the first surgery, all dogs retained full control over urination immediately after recovery from anesthesia. In one case that required reoperation, complete urinary incontinence occurred after the second procedure. The present findings suggest that hybrid surgery can be used to treat distal urethral tumors. Qualification for surgery must be limited to bitches with tumors of the distal urethra and without metastases, without the possibility of using other surgical methods, and with the owner's full acceptance of the risk of complications.