Associate Professor Charles Sturt University Wagga Wagga, New South Wales, Australia
A 5 month-old Warmblood filly was presented for treatment of persistent urinary incontinence and urine scalding. Vaginal endoscopic examination under standing sedation located the opening of a left sided ectopic ureter cranial and abaxial to the vestibular fold on the floor of the vagina, unassociated with the urethral orifice. Under general anaesthesia and in right lateral recumbency the ectopic ureter was catheterized using a size 12 foley catheter under endoscopic guidance. Advancing the catheter cranially allowed its visualization from within the bladder, thereby confirming the intramural location of the ectopic ureter. With the catheter balloon inflated and positioned level with the correctly developed right ureteral papilla, a combination of sharp (laparoscopic scissors) and electrosurgical instruments (Ligasure™) were used to dissect onto the inflated ballon. The dissection was extended until the ureteral lumen was breached as evidenced by the collapse of the catheter balloon and ingress of urine. Using the vessel sealing device the fenestration was then extended to measure approximately 1 cm in length. The distal (vaginal) opening of the ectopic ureter was left open. The filly recovered uneventfully from anaesthesia. Post-operative care consisted of intravenous antibiosis and non-steroidal medications. Urinary incontinence was drastically reduced within 24 hours and completely subsided over the following 2 weeks. Repeat cystoscopy 3 weeks post operatively confirmed an open ureteral stoma and no further evidence of urinary incontinence.
