ArticleJournal of feline medicine and surgery2025
Cystoscopy-assisted urolith retrieval via a perineal urethrostomy stoma in male cats.
Article in Journal of feline medicine and surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
ObjectivesWe sought to characterize cystoscopy-assisted urolith retrieval via a perineal urethrostomy stoma (CUPU) initially in a cadaveric model and then in clinical cases. We hypothesized that a CUPU would provide a reasonable alternative to the traditional approach of performing a cystotomy after perineal urethrostomy in male cats with complex or recurrent urolithiasis-associated urethral obstruction (UO).MethodsA perineal urethrostomy (PU) was performed in 20 male cat cadavers. A randomly assigned number of synthetic calculi (SynC) was placed retrograde into the urinary bladder, and an endoscopist blinded to the SynC number, performed CUPU using a flexible ureteroscope and basket retrieval device. Procedure characteristics were summarized with descriptive statistics. After completion of the cadaver phase, two male cats with naturally occurring complex or recurrent urolithiasis-associated UO that warranted PU were recruited to undergo CUPU. Clinical features and outcomes of these cases were described.ResultsFour cadavers were excluded because of urethral tearing during SynC placement. A narrow urethral lumen precluded ureteroscope passage in two cadavers. In the 14 remaining cadavers, a median of 7.5 SynC (range 3-9) were placed in the urinary bladder. The CUPU median procedural time was 13.2 mins (range 6.1-24.0) and all 99 (100%) SynC were successfully retrieved from the 14 cadavers. Scope-associated tearing of the urethra or surgical site was not observed in any cadavers. Two client-owned cats with struvite urolithiasis-associated UO underwent a PU followed by CUPU. All uroliths were successfully retrieved, and periprocedural complications were not observed. Both cats had normal stoma sites 4 weeks postoperatively and neither cat had owner-reported dysuria 3 months postoperatively.Conclusions and relevanceThis study highlighted that CUPU is a feasible procedure with the potential to obviate the need for abdominal surgery in some cats with cystolithiasis and urolithiasis-associated UO that warrant PU.
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