Progressive urethral dilation in male horses undergoing perineal urethrotomy for cystolith removal: 22 cases.
Authors: Sassot Lucas Nolazco, Ragle Claude, Pentzke-Lemus Ligia, Jones Andrew Richard Ellis, Farnsworth Kelly
Journal: Journal of equine veterinary science
Summary
# Editorial Summary: Progressive Urethral Dilation for Cystolith Removal in Stallions and Geldings Cystoliths represent a significant urogenital problem in male horses, but their surgical management—particularly when stones are large or impacted—remains technically challenging. This retrospective case series examined whether progressive dilation of the pelvic urethra during perineal urethrotomy could improve outcomes in 22 horses undergoing cystolith removal, with stones ranging from 37 to 90 mm. The surgical team employed customised dilators (25–45 mm outer diameter) following urethrotomy, removing calculi either intact (n=6) or via mechanical lithotripsy using forceps (n=9) or pneumatic scalers (n=7), with retrieval devices assisting in 15 cases. Remarkably, only one intra-operative complication occurred across the cohort, zero post-operative complications were documented, hospitalisation lasted 1–5 days, and follow-up data spanning up to 8 years (available for 21 horses) suggested durable outcomes. For practitioners managing recurrent or large uroliths in male horses, this evidence suggests that deliberate progressive urethral dilation can reduce stricture formation risk and improve stone extraction efficiency whilst maintaining excellent safety margins—a technique worth considering as part of the perineal urethrotomy protocol.
Read the full abstract on PubMed
Practical Takeaways
- •Perineal urethrotomy with progressive urethral dilation can successfully treat cystoliths in male horses with minimal post-operative complications and short hospitalization periods.
- •Customized dilators with varying diameters (25-45mm) allow tailored approaches to individual cases while maintaining consistent length (30cm).
- •This technique appears safe for long-term follow-up (up to 8 years), making it a practical option to add to your cystolith removal protocols in practice.
Key Findings
- •Progressive urethral dilation following perineal urethrotomy was performed successfully in 22 male horses with cystolith sizes ranging from 37-90mm.
- •Cystolith removal was achieved without fragmentation in 6 horses and with lithotripsy (forceps or pneumatic scaler) in 16 horses, with retrieval devices used in 15 cases.
- •Hospitalization ranged 1-5 days with only 1 intra-operative complication and no post-operative complications recorded.
- •Follow-up data available for 21 horses over 1-8 years demonstrated progressive urethral dilation via perineal urethrotomy as a viable treatment option for equine cystolithiasis.