The retrograde urine flow from the bladder to the upper urinary tract, known as vesicoureteral reflux (VUR), is an uncommon abnormal disorder in dogs. VUR results from anatomical defect of the ureterovesical junction (UVJ) or abnormal increased vesical pressure due to obstruction.
To report a case of successful laparoscopic repair of vesicoureteral reflux in a dog.
The patient, a male German Shepherd, age 3 months, was presenting with vomiting, dysuria, oliguria, tenesmus and anorexia. Abdominal echography revealed dilatation of both ureters slightly distal to the UVJ and early evidence of hydronephrosis in both kidneys. The patient was submitted to laparoscopic antireflux ureterocystoplasty. Abdominal ports were placed in triangulation on the umbilicus scar (10 mm) and left (5 mm) and right (10 mm) lateral areas. Initial inspection revealed moderate bilateral ureteral dilatation. For surgical repair, the UVJs were preserved and the distal end of the ureters was buried in vesical submucosal tunnels that were performed using laparoscopic Metzenbaum scissors. The serosa overlapping over the ureter ends was performed using intracorporeal simple interrupted sutures with 3-0 polyglactin 910 thread. Finally, omentopexy was performed over the tunnel site.
The patient convalesced uneventfully and was discharged following seven days. On the 10th day post-op a new echography was performed and the ureters and kidneys were within the normal parameters and patterns.
Laparoscopic ureterocystoplasty was both feasible and effective in restoring adequate urine flow in a pediatric dog and should be considered as a treatment choice in case-selected patients.