Case Report: Successful management of bilateral ureteral obstruction following repair of iatrogenic urethral ligation and transection during a canine cryptorchidectomy.

Abstract

An 8-month-old male English Bulldog was presented to an academic referral center following iatrogenic urethral transection during an elective unilateral cryptorchidectomy. A contrast cystourethrogram demonstrated contrast leakage from the pre-prostatic urethra. An exploratory laparotomy confirmed ligation and transection of the pre-prostatic urethra, and a urethral anastomosis was performed. Postoperatively, the patient developed progressive azotemia, and abdominal imaging revealed bilateral hydroureter and hydronephrosis consistent with bilateral ureteral obstruction. No apparent cause of mechanical obstruction was identified during the subsequent ultrasound, cystoscopy, or laparotomy. A functional ureteral obstruction was suspected to be caused by acute, severe inflammation of the urinary bladder following the initial urethral trauma and subsequent ischemic injury, resulting in the occlusion of the ureteral papillae. Bilateral ureteral stents were surgically placed, and the azotemia resolved. Following stent placement, the dog was treated for recurrent multidrug-resistant urinary infections and urinary incontinence. The owner reported no persistent lower urinary signs during a follow-up call 46 months following the cryptorchidectomy.