Bilateral ureterocystostomy to correct left ureteral atresia and right ureteral ectopia in an 8-month-old standardbred filly.
Authors: Getman Liberty M, Ross Michael W, Elce Yvonne A
Journal: Veterinary surgery : VS
Summary
# Editorial Summary Congenital ureteral anomalies in foals present a significant surgical challenge, yet little literature exists documenting successful outcomes in larger animals. This case report describes the diagnosis and repair of bilateral distal ureteral defects—left ureteral atresia with secondary hydronephrosis and right ureteral ectopia—in an 8-month-old, 310 kg Standardbred filly presenting with lifelong incontinence and severe perineal urine scalding. Multimodal imaging proved essential to surgical planning: cystoscopy and vaginoscopy directly visualised the anatomical defects, whilst intravenous pyelography, ultrasonography, and nuclear scintigraphy quantified renal function and localised ectopic ureteral openings. The surgical team corrected the left side via end-to-side stapled ureteral-to-bladder anastomosis and the right side using side-to-side hand-sewn technique, achieving full continence without postoperative complications and demonstrating modest recovery of left renal function at 18-month follow-up. This outcome suggests that even extensive bilateral ureteral pathology in heavy foals is amenable to surgical repair, with nuclear scintigraphy emerging as a critical diagnostic tool for prognostication in cases where hydronephrosis threatens residual kidney function—particularly relevant for practitioners managing young performance horses presenting with congenital incontinence.
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Practical Takeaways
- •Congenital ureteral anomalies causing incontinence and urine scalding in foals can be surgically corrected with good outcomes, even in larger foals >300 kg.
- •A combination of diagnostic imaging (cystoscopy, vaginoscopy, intravenous pyelography, ultrasonography, and scintigraphy) is important for complete characterization of ureteral anomalies and assessment of renal function before surgical planning.
- •Surgical correction may partially restore renal function, making it worthwhile to consider operative intervention rather than assuming permanent dysfunction in foals with hydronephrosis from ureteral anomalies.
Key Findings
- •Bilateral ureteral anomalies (left atresia and right ectopia) were successfully corrected surgically in an 8-month-old Standardbred filly using end-to-side and side-to-side anastomosis techniques.
- •The filly achieved continence and remained continent 18 months postoperatively with no complications.
- •Left renal function improved following surgical correction despite preoperative hydronephrosis and decreased function.
- •Scintigraphy proved valuable for diagnosis, assessment of renal function, and prognostication in cases of ureteral anomalies.