Treatment of a urethral stricture by image-guided placement of a custom-made absorbable stent in a standing, sedated horse.
Authors: Baltrimaite Milda, Kearney Clodagh, O'Brien Anne, Duggan Michael, Cuq Benoît
Journal: Journal of veterinary internal medicine
Summary
# Editorial Summary A 10-year-old Irish Sport Horse gelding developed iatrogenic urethral stricture following repeated catheterisation during post-operative management, resulting in dysuria and incomplete bladder emptying unresponsive to conservative treatment with topical corticosteroids and balloon dilation. Using image-guided ultrasound and urethroscopy, clinicians placed a custom-made polydioxanone (biodegradable) stent directly into the strictured urethra whilst the horse remained standing under sedation, avoiding the risks associated with general anaesthesia in a compromised patient. At 6-month follow-up imaging, the stent had completely reabsorbed and the urethra remained patent, with the horse achieving normal micturition and complete bladder evacuation; this functional improvement persisted through 19-month follow-up with the horse returning to full athletic performance. This case demonstrates that minimally invasive, standing stent placement offers a viable alternative to conventional surgical approaches for managing iatrogenic urethral strictures, particularly in horses where repeat general anaesthesia carries elevated risk, and highlights the value of absorbable materials that provide temporary structural support whilst permitting tissue remodelling. For practitioners managing post-catheterisation complications or dysuria unresponsive to standard protocols, consultation regarding image-guided stenting may preserve athletic function and avoid more invasive surgical interventions.
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Practical Takeaways
- •Image-guided custom absorbable stent placement offers an effective alternative to repeated catheterization and conservative management for urethral strictures refractory to medical therapy
- •Standing sedation procedure eliminates general anesthesia risks in horses with prior anesthetic complications and allows for safer treatment of iatrogenic strictures
- •Complete epithelialization occurred after stent reabsorption, providing longer-term patency without permanent implant complications
Key Findings
- •Custom-made polydioxanone stent successfully treated iatrogenic urethral stricture in a standing, sedated horse using image-guided placement
- •Complete bladder emptying and normal micturition restored immediately following stent placement
- •Stent completely reabsorbed within 6 months with urethra remaining patent on repeat urethroscopy and ultrasonography
- •Horse returned to intended athletic performance level with no dysuria recurrence at 19 months post-procedure