Radical cystectomy and subsequent ureterohysterostomy in a bitch

Objective: To describe and report the outcome of a ureterouterine anastomosis after unilateral dehiscence of a ureterovaginal anastomosis after total cystectomy in a bitch. Study design: Case report. Animal: A 10-year-old intact female border collie with a urinary bladder leiomyosarcoma. Methods: The dog was diagnosed with an invasive urinary bladder tumor, treated by radical cystectomy and bilateral ureterovaginal anastomosis. Postoperative necrosis of the distal ureter led to dehiscence of the anastomosis on the right side. To preserve the right kidney, the right ureter was anastomosed to the right uterine horn, and a stent was placed across the uterine cervix. Results: The dog recovered from surgery and regained satisfactory urine output. Both ureteral anastomoses were patent at 10 months postoperatively. At 12 months postoperatively, intraluminal obstruction of the uterine stent, loss of patency of the right ureter, and severe right renal hydronephrosis were noted. The owner declined nephrectomy, and the dog died 2 months later. Conclusion: This is the first published report of a ureterouterine anastomosis and stenting of the uterine cervix in a dog. The functional outcome was satisfactory for 1 year postoperatively. The uterine stent and distal ureter were eventually obstructed by soft tissue. Clinical significance: Ureterouterine anastomosis can be considered as a salvage procedure when other surgical techniques have failed.