An 18-month old female mixed breed dog was evaluated for a 6-month history of urinary incontinence that developed post-ovariohysterectomy. She had several urinary tract infections previously confirmed with urinalysis and urine culture. Her incontinence was non-responsive to twice daily phenylpropanalomine. Abdominal ultrasound is shown below and was suspicious for bilateral ectopic ureters.
What further diagnostics can be used to confirm the presence of ectopic ureters?
What percentage of ectopic ureters in dogs are intramural?
What are the treatment options for intramural ectopic ureters? For extramural ectopic ureters?
Cystoscopy was performed and a still image and video are shown below. A 3 French ureteral catheter was advanced into each ureteral opening individually. Iodinated contrast agent was diluted in a 1:1 ratio with sterile saline. The bladder was moderately distended with contrast agent via the working channel of the rigid cystoscope before infusion of diluted contrast agent into the ureteral catheter under constant fluoroscopic visualization to confirm the ureters both coursed intramurally. A diode laser set at 22 watts was placed into the working channel of the rigid cystoscope and used to laser ablate the intra-luminal surface of the ectopic ureters into the lumen of the bladder.
What are the risks associated with laser ablation of ectopic ureters?