Tube Cystotomy Research Articles

Comparative evaluation of conventional and ultrasound assisted tube cystotomy for obstructive urolithiasis in cattle

The aim of this study was to evaluate the efficacy of conventional and ultrasound assisted tube cystotomy techniques for obstructive urolithiasis in 12 cattle by allowing two groups. Group-I, animals were subjected to conventional tube cystotomy, whereas in group- II, ultrasound assisted tube cystotomy was performed using Foley’s catheter under deep sedation with xylazine hydrochloride and local infiltration anaesthesia. Clinically, all animals showed urethral pulsation, dribbling of urine, futile attempts, bellowing, congested mucous membrane, sunken eyes, dry muzzle and teeth grinding. Non-significant changes were observed in haematological and biochemical values, however neutrophilia and alkaline pH of urine was prominent. Ultrasound assisted tube cystotomy technique consumed less time (40.00±1.29 min) with small incision and minimal bleeding as compared to conventional tube cystotomy.

P2X7 receptor knockout does not alter renal function or prevent angiotensin II-induced kidney injury in F344 rats

P2X7 receptors (P2X7) mediate immune and endothelial cell responses to extracellular ATP. Acute pharmacological blockade increases renal blood flow (RBF) and glomerular filtration rate (GFR), suggesting that P2X7 receptor activation promotes tonic vasoconstriction. P2X7 expression is increased in kidney disease and blockade/knockout is renoprotective. Here, we generated a novel P2X7 global knockout (KO) rat on the F344 background, hypothesising enhanced RBF and protection from chronic angiotensin II (ANG II)-induced injury. CRISPR/Cas9 technology introduced an early stop codon into exon 2 of P2rx7. In male and female KO and WT rats, renal P2X7 expression was measured by RTqPCR (n=4-5/group) and western blotting (n=3/group). Bone marrow-derived macrophages (BMDM) were used to assess P2X7 function by measuring interleukin (IL)-1β release (ELISA) after stimulation with lipopolysaccharide (LPS) (1μg/mL, 4h) and ATP (3mM, 1h) (n=5-6/group). In vivo kidney function was assessed in anesthetized rats (thiopental, 50mg/kg, i.p.) at baseline and following serial arterial ligation to induce acute pressure natriuresis (n=9-10/group). Arterial blood pressure (BP) was measured directly, and urine was collected via tube cystotomy. RBF was measured using a Transonic Doppler flow probe placed around the main renal artery, and cortical and medullary flux by laser Doppler needle probes. GFR was determined by FITC-inulin clearance. Urinary sodium was measured by sodium-selective electrode analysis. In a separate experiment, BP was recorded over five consecutive days in conscious male KO and WT rats via implanted radiotelemetry devices (n=7-8/group). Finally, male KO and WT rats (n=9-10/group) were infused with ANG II (250ng/kg/min, s.c.) for 6 weeks. At end, one renal artery was isolated and vascular reactivity to phenylephrine, acetylcholine and sodium nitroprusside determined by wire myography. Bladder urine was collected to measure albumin/creatinine ratio (n=4-7/group), and kidneys were harvested for histological analyses (n=6/group). Data were analysed with unpaired t-test (two groups compared) or two-way ANOVA (two variables), with p<0.05 statistically significant. P2rx7 mutation was confirmed by genome sequencing (Sanger). P2rx7 mRNA abundance was partially decreased in kidney from male (-54%) and female (-25%) KO vs WT. P2X7 protein was detected in kidneys from WT but not from KO rats. In BMDM from WT rats, LPS+ATP stimulation induced IL-1β release; this response was markedly suppressed in KO BMDM (males: 2577±140 vs 413±175pg/mL, p<0.0001; females: 1889±394 vs 265±121pg/mL, p<0.0001). In vivo BP, renal haemodynamics and tubular sodium handling were not different between genotypes for either sex (P>0.05). Radiotelemetry confirmed no difference in BP between KO and WT rats. Following chronic ANG II infusion, KO and WT rats had no renal artery dysfunction but showed similar increases in albuminuria (P=0.3587), renal perivascular fibrosis (Picrosirius Red, P=0.5393), cortical interstitium CD68-positive area (p=0.6546) and tubular casts (Periodic acid-Schiff, P=0.8803), compared with naïve controls. Contrary to our hypothesis, global genetic deletion of P2X7 did not affect renal hemodynamics and we found no significant role for P2X7 in the modulation of tubular sodium reabsorption. Our data do not support a major role of P2X7 in causing renal vascular and tubular injury. This work was supported by Diabetes UK grant 17/0005685, The British Heart Foundation(FS/15/60/31510; RE/18/5/34216), the Medical Research Council (MR/S01053X), and the University of Edinburgh College of Medicine & Veterinary Medicine PhD Studentship. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

A systematic review on urolithiasis in small ruminants according to nutrition-dependent prevalence and outcome after surgery.

Background and Aim:Obstructive urolithiasis is a common disease in small ruminants with fatal outcomes if left untreated. Many methods have been established; however, long-term success rates remain unsatisfactory. Four bibliographic databases (PubMed, HeBis, Medline (OvidSP), and Web of Science) were searched to evaluate the prevalence of urolithiasis in small ruminants and long-term outcomes after surgery using a systematic review. The study aimed to give evidence-based data concerning prevalence and success rates after surgery.Materials and Methods:The analysis included 24 (total 239) peer-reviewed journal articles dealing with the prevalence of urolithiasis and 16 (total 39) concerning long-term outcomes after surgery. Literature was included if it referred to species, language, availability, and relevant statements to the specific questions, including the presence of control groups. Heterogeneity tests included Χ2, I2, and τ2, respectively. A 95% confidence interval was determined, and effects were estimated using the fixed effect model. Due to a feeding-associated bias, prevalence analysis was conducted for a sorghum-based and a corn-based feeding resulting in a weighted prevalence of 62% and 17%, respectively. Analysis of long-term outcomes after surgical interventions revealed long-term success rates of 15-77% after ultrasonographic tube cystotomy and marsupialization of the urinary bladder, respectively.Results:The prevalence of urolithiasis is strongly associated with feeding and may be calculated as 17% in corn-based rations and 62% in sorghum-based rations. Surgical interventions result in guarded to moderate long-term success rates of 15-66%. Urethral stoma and marsupialization of the bladder provide acceptable long-term success rates with 71-77% but are rather salvage techniques than accepted surgical methods, especially when used in companion animals.Conclusion:The development of urolithiasis is mainly influenced by nutrition. Effective prophylaxis of this disease should, therefore, always include advisory service for the owners. Existing surgical techniques should be critically re-evaluated concerning their long-term success rates.

Management of urolithiasis in male Kankrej bovines

The study included 30 male Kankrej bovines showing symptoms of urinary obstruction. All the animals were clinically examined for the colour of conjunctival mucous membrane, capillary refill time, fluid thrill and distension of abdomen, and evaluated ultrasonographically. Ultrasonographic examination (transabdominal and trans-rectal) provided quick and definitive information about the status of urinary bladder. Surgical treatment was done in 17 bovines; post-scrotal urethrotomy in 9 bullocks, and tube cystostomy in 8 calves. Surgical intervention, urethrotomy or tube cystotomy, along with oral feeding of ammonium chloride yielded good results.

Dinner plan killers

Urinary obstructed small ruminants, pigs in dystocia, and pregnancy toxemia all represent challenging, truly emergent clinical scenarios in mixed and large animal practice. Each of these scenarios, however, lend themselves to protocol development. Putting these cases on autopilot can remove a lot of the associated stress and ensure consistent patient care with consideration for client expectations and finances built right in.
 Initial evaluation of animals with suspected urolithiasis should include examination of the preputial hairs for grit or formed stones and exteriorization of the penis for examination and amputation of the vermiform appendage. When vermiform appendage amputation fails to relieve the obstruction, catheterization and surgical intervention, including perineal urethrostomy, tube cystotomy, minimally invasive tube cystotomy, and others should be considered.
 Swine presented for dystocia are often compromised and require a Cesarean section. Having a standard protocol in place for perioperative drugs, including anesthetic drugs, antimicrobials, and anti-inflammatories, reduces the veterinarian’s stress in preparing to go to surgery. Unlike other species, the surgical approach in swine is paramammary and the uterus is much more highly vascularized. Care must be taken to minimize abdominal contamination where dead piglets are involved.
 Ewes and does presented ill in late gestation should always be evaluated for pregnancy toxemia. Many, if not most of these animals, additionally have pneumonia and a GI parasite burden. Does and ewes that are still standing and eating can often be managed in the field, while those that are recumbent will only recover if placed on IV fluids and dextrose CRI. Producers must be educated on pregnancy toxemia risk factors, such as obesity, parasitism, and improper feeding.

Ultrasound guided tube cystotomy in buffalo calves

In the present investigation, 39 desi (Gossypium arboreum L.) genotypes along with three checks viz., AKA-7, PA-08 and JLA-794 were studied to observe genetic variability, heritability and genetic advance for fifteen yield contributing and fiber quality characters. Analysis of variance showed significant differences for all the characters among genotypes indicating the presence of wide range of genetic variability in the experimental materials. The high GCV and PCV were observed for number of boll per plant, seed cotton yield per plant, number of sympodia per plant, lint index and plant height. High heritability estimates coupled with high expected genetic advance were observed for the characters number of boll per plant, seed cotton yield per plant, number of sympodia per plant, lint index, plant height and micronaire. It indicates the presence of additive gene action and phenotypic selection may be more fruitful and effective for desired genetic improvement.

Modified tube cystotomy for management of obstructive urolithiasis in young male bovines: A review of 9 cases

Obstructive urolithiasis is majoritily a complaint of male calves with tube cystotomy as the advised treatment however the tube blockage is one of the post surgical complaints This complication is reduced when modified technique of single stab incision is used for insertion of tube in abdominal cavity The present study was conducted on male bovine calves Cattle and Buffalo presented with history of anuria and anorexia Trans abdominal B mode ultrasonograhic examination with MHz transducer was adequate to visualize the urinary bladder in all calves The urinary bladder was intact in calves whereas in remaining calves urine was present in the peritoneal cavity either due to complete n or subserous n rupture of the urinary bladder Modified tube cystotomy followed by oral feeding of ammonium chloride gm total dose daily up to days is practical and field applicable method for treatment of obstructive urolithiasis in male bovine calves

Surgical management of urinary obstruction in young ruminants by tube cystotomy: A report of 24 cases

Objectives: To assess the efficacy of tube cystotomy along with medical dissolution of calaculi as a sole strategy for correction of obstructive urolithiasis in young ruminants. Materials and methods: Young bull calves (n=24; 10 Ongole claves and 14 Murrah buffalo calves) suffering from complete/partial urinary retention aging between 1 to 6 months were treated by tube cystotomy along with oral administration of ammonium chloride dosed at 10 gm/Kg body weight (bwt) orally for 15 days, streptopencillin dosed at 100 mg/10 Kg bwt through intramuscular (im) route for 5 days, and meloxicam dosed at 0.2 mg/Kg bwt through im route for 3 days. Results: Total 23 (95.83%) out of 24 calves started passing urine normally through the natural orifice 10-15 days postoperatively. None of the recovered animals (n=23) exhibited recurrence of symptoms, establishing the superiority of the technique in resolving the condition. Conclusion: Tube cystotomy, when performed at an early stage can prevent mortality of calves due to cystorrhexis, uroperitoneum and consequent uremia. This can avoid the painful and most tedious cysto-urethrotomy in young ruminants. http://doi.org/10.5455/javar.2016.c142

Laparoscopic Tube Cystotomy as a New Trend for Treatment of Obstructive Urolithiasis in Small Ruminants

The current study was planned to clarify the benefit from using laparoscopic tube cystotomy in treatment of obstructive urolithiasis especially in the cases that do not respond to urethral process amputation. For this purpose, 14 small ruminant cases were selected from 20 animals with obstructive urolithiasis. Another six cases that responded to urethral process amputation were also included. The disease was diagnosed based on clinical and ultrasonographic examinations. Laparoscopic tube cystotomy was performed by creating a diversion of urine from the urethra and voiding the urine temporarily from a foley catheter inserted inside the urinary bladder. In conclusion, this technique proved to be feasible in rams and bucks and can be used as an alternative to the open conventional tube cystotomy in cases of urine retention syndrome providing a minimal invasive tissue trauma and regaining the normal urination pathway in all treated cases.

Laparoscopic‐assisted tube cystotomy for urethral rupture in a foal

SummaryA 10‐day‐old Tennessee Walking Horse colt was hospitalised due to a pelvic urethral tear. After 2 unsuccessful attempts to repair the tear by primary closure, the colt underwent perineal urethroplasty and laparoscopic‐assisted tube cystotomy which permitted complete urine diversion and allowed the urethral tear to heal completely.

English

The cases of urolithiasis in caprine and sheep presented for treatment for one year to University Teaching Veterinary Clinics were managed surgically. A brief history about the clinical cases, their clinical examination, kidney function tests and ultrasonography was studied. The cases were surgically managed by performing different surgical procedures viz, excision of urethral process, urethrotomy perineal urethrotomy, tube cystotomy and cystorrhaphy and modified bladder marsupialisation as demanded by clinical situation. The postoperative management, survival rates and restoration of normal urination, rupture sites and return of normal kidney function tests of the cases has been discussed. Key words: Urine, ultrasound, urethrotomy, bladder.

Successful management of uroperitoneum in a neonatal pony foal by tube cystotomy using infusion set tubing

A male pony foal aged 2 days, reportedly not passing urine since birth and showing moderate signs of colic, was presented for treatment. The clinical examination revealed moderate tachycardia, tachypnea, and mild abdominal distension. Uroperitoneum was confirmed by peritoneocentesis and abdominal fluid-to-serum creatinine ratio (>2:1). After stabilization of the patient, tube cystotomy was performed using infusion set tubing to bypass the urine, allowing the tear on the caudodorsal wall of the bladder to heal itself without suturing. The foal resumed normal urination on day 6 and the catheter was removed 3 days later. Complications were not detected during the 3-month observation period.

A clinical case: Vitamin C-responsive dermatosis in a Holstein native cross bull calf

A male pony foal aged 2 days, reportedly not passing urine since birth and showing moderate signs of colic, was presented for treatment. The clinical examination revealed moderate tachycardia, tachypnea, and mild abdominal distension. Uroperitoneum was confirmed by peritoneocentesis and abdominal fluid-to-serum creatinine ratio (>2:1). After stabilization of the patient, tube cystotomy was performed using infusion set tubing to bypass the urine, allowing the tear on the caudodorsal wall of the bladder to heal itself without suturing. The foal resumed normal urination on day 6 and the catheter was removed 3 days later. Complications were not detected during the 3-month observation period.

Management of obstructive urolithiasis in dairy calves with intact bladder and urethra by Fazili’s minimally invasive tube cystotomy technique

The present study was planned to evaluate minimally invasive tube cystotomy technique in calves suffering from obstructive urolithiasis having intact urinary bladder and urethra. Fifteen male non-castrated calves with age ranging from 1-10 months (mean 4.05 months), presented for treatment within one to three days (mean 2.2 days) of complete urinary tract obstruction due to urethral calculi with intact bladder and urethra, were included in this study. Under light sedation and local infiltration anaesthesia, all the animals were subjected through left paralumbar fossa, to a minimally invasive surgical tube cystotomy in which catheter was placed in the bladder lumen through a metallic cannula and fixed to the skin with a stay suture (Fazili’s technique). All the animals were discharged the same day. Time taken for the procedure varied from 8 to 17 minutes (mean 11.0 minutes). Normal urination resumed in twelve (80.0%) calves. Mean time taken for normal urination was 10.50 days. In two of the remaining calves, urine flow stopped through the catheter prematurely and they were then subjected to standard surgical tube cystotomy. One more calf did not urinate normally for 30 postoperative days and was lost to the follow up thereafter. Recurrence of the obstruction was not detected in ten and nine animals observed up to six and 12 months respectively. In conclusion, the outcome of this minimally invasive technique is similar to the standard tube cystectomy. Additionally, the procedure is cost effective, quick, simple and field applicable. It also minimizes exposure of abdominal cavity of metabolically compromised animals. However, the technique needs to be tried in larger number of such calves wherein better quality catheter of larger diameter be used before recommending its extensive use.

Management of obstructive urolithiasis in dairy calves with intact bladder and urethra by Fazili’s minimally invasive tube cystotomy technique

Management of obstructive urolithiasis in dairy calves with intact bladder and urethra by Fazili’s minimally invasive tube cystotomy technique

Obstructive urolithiasis in a Saanen goat in New Zealand, resulting in a ruptured bladder

CASE HISTORY: A 3-year-old male, castrated Saanen goat was presented with an acute onset of vocalisation, abdominal discomfort and ‘tail-flagging’. CLINICAL FINDINGS: Radiographs, including a positive-contrast study, indicated obstructive urolithiasis, and evidence of rupture of the urethra. Analysis of uroliths identified calcium carbonate crystals. Amputation of the urethral process could not re-establish urethral patency, so a tube cystotomy was performed but also was not successful. Eighteen days after admission, a perineal urethrostomy was performed. However, the goat's condition deteriorated 12 days after the urethrostomy, and the owner consented to euthanasia of the animal. Post-mortem examination revealed a hole 2 x 1 cm on the dorsal aspect of the bladder, and a necrotic focus measuring approximately 2 x 3 cm ventrally. DIAGNOSIS: Obstructive urolithiasis, with ruptured bladder and urethra. CLINICAL RELEVANCE: Obstructive urolithiasis is probably an under-reported condition of castrated male goats in New Zealand.

Potential complications following urethral obstruction in rams

POTENTIAL COMPLICATIONS Urethral rupture In some neglected cases, rupture of the urethra/penis may occur, with subcutaneous urine accumulation up to 8 cm deep extending cranially from the scrotum to the prepuce. After several days, large, sharply-demarcated areas of purple-discoloured skin develop along the ventrum overlying the subcutaneous urine accumulation. This discoloured skin becomes cold, and, with associated necrotic muscle, will slough after 10-14 days, if the animal survives the uraemic state and urinary back pressure/hydronephrosis. In such cases, even if tube cystotomy surgery is successful, considerable sloughing occurs. The multiloculated sonographic appearance of the subcutaneous swelling indicates that drainage through a single or multiple skin incisions would not readily occur.

Minimally invasive surgical tube cystotomy for treating obstructive urolithiasis in small ruminants with an intact urinary bladder

Ten young, male, entire small ruminants (seven kids and three lambs) with obstructive urolithiasis, which were presented within three days of complete blockage and before rupture of the urinary bladder...

Laparoscopic-assisted implantation of a urinary catheter in male sheep

OBJECTIVE-To evaluate a laparoscopic technique for implantation of a urinary catheter in the right paramedian area in male sheep and to determine feasibility, benefits, and risks for this technique. DESIGN-Evaluation study. ANIMALS-6 Healthy male sheep (mean +/- SD body weight, 42.16 +/- 11.95 kg [92.75 +/- 26.29 lb]). PROCEDURES-Each sheep was anesthetized and positioned in dorsal recumbency. A 10-mm laparoscope was inserted in the right paramedian area between the xiphoid and preputial orifice. After creation of capnoperitoneum, grasping forceps were inserted in the left paramedian area at the level of the teats and used to immobilize the urinary bladder. A pigtail balloon catheter was implanted transcutaneously in the right paramedian area between the preputial orifice and teats and directed into the urinary bladder by use of laparoscopic guidance. The catheter was removed 10 days after implantation. Fourteen days after initial surgery, a second laparoscopy was performed to evaluate pathologic changes. RESULTS-Inadvertent insertion of the first trocar into the rumen of 1 sheep was the only intraoperative complication encountered. Laparoscopic-assisted implantation of the urinary catheter was successfully performed in all sheep. No postoperative complications were detected. CONCLUSIONS AND CLINICAL RELEVANCE-Laparoscopic-assisted implantation of a urinary catheter in the right paramedian area was successfully performed and may be a feasible method for use in sheep. This method can be considered as an alternative to tube cystotomy performed by laparotomy.