Urethral Stricture and Urethral Stent Placement in a 9-year-old Border Collie
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A 9-year-old male intact Border Collie presented to Cornell’s Emergency Service on 7/2/17 for urethral obstruction. The patient first showed stranguria on 7/1/17 and was initially taken to an emergency clinic. Urinary catheterization was attempted unsuccessful, therefore he was referred to Cornell after performing cystocentesis to temporarily alleviate discomfort and post-renal obstruction.
On presentation to Cornell’s Emergency Service, the patient was bright, alert, and responsive. Physical exam revealed a very tense abdomen, as well as multiple areas of alopecia with abrasions on his caudal dorsum, ventrum and scrotum. A 5-Fr urinary catheter was passed successfully with difficulty at the base of os penis. The patient was maintained on IV fluids, dexmedetomidine constant rate infusion (CRI), Unasyn and methadone.
The patient was transferred to Cornell’s Soft Tissue Surgery Service the following morning for continued work up and further assessment. Urethrogram identified a stricture at the base of os penis. The urethral diameter was 4 mm cranial and caudal to the stricture. At the level of the stricture, the urethra narrowed to 1.3 mm. The stricture extended over a distance of 44 mm. Treatment options including medical management and ballooning or stenting of the stricture were discussed. Surgical treatment was elected. The patient was placed under general anesthesia and the stricture ballooned to a diameter of 6 mm. A transluminal open weave laser cut urethral stent (60 mm x 6 mm) was placed under fluoroscopic guidance.
The patient recovered in the intensive care unit overnight while being maintained on dexmedetomidine CRI, prazosin and bethanachol. He was discharged the following afternoon, at which time he was urinating a full stream with complete voiding of the urinary bladder. This case report will discuss the treatment and prognosis for urethral stricture, as well as the management difficulties of urethral obstruction.