CYSTOTOMY

The American College of Veterinary Surgeons (ACVS) has a comprehensive review of urolith (urinary stone) types, causes and many photos. We encourage you to explore this link to better understand what is happening with your pet.

Overview

Cystotomy is a surgical procedure in which an incision is made into the urinary bladder. The procedure can be done for many reasons, the most common being to facilitate removal of bladder and urethral stones. Other indications include helping to diagnose bladder tumors, repairing ectopic ureters and ruptured bladders, and aiding in the diagnosis of difficult-to treat urinary tract infections. Depending on your pet’s age and overall health, blood work may be performed prior to anesthesia. Because general anesthesia is necessary, this information will help your veterinarian assess your pet’s kidney and liver function, as well as his overall health. Your veterinarian will also use this information to help determine the safest anesthetic regime for your pet.

Procedure

The skin incision is made on the midline of female dogs, but must be off to one side to avoid the male dog’s prepuce and penis. The bladder is gently elevated out of the abdomen and an incision is made through its wall. Urine is suctioned away and the inside of the bladder is examined. After opening the bladder, stones (uroliths) are removed from the bladder or they are flushed into the bladder from the urethra and then removed. If a tumor is suspected, a sample of the bladder wall can be excised (cut away) and sent to the laboratory for biopsy. When infection is suspected a piece of the bladder wall and a sample of the stone that was removed are submitted for culture (to determine what bacteria arepresent) and antibiotic sensitivity (to determine which antibiotics the bacteria are most sensitive to). If ectopic ureters are identified, they are repaired.

The incision in the bladder is sutured and the abdomen is flushed with sterile saline to remove any debris or urine that might have leaked into it. The incision in the body wall and skin are then sutured. Animals can be painful after any abdominal surgery and they are often given analgesics to keep them  comfortable. Injectable or oral antibiotics may also be given to the patient after surgery if a urinary tract infection is suspected.