Benign ureteral obstruction in cats treated surgically: a retrospective review of 105 cats

ObjectivesThe aim of the present study was to report the postoperative short- and long-term outcomes in cats with benign ureteral obstruction treated surgically with ureteral stent, subcutaneous ureteral bypass (SUB) or ureterotomy.MethodsSignalment, surgery time, hospitalization duration, pre- and postoperative biological and biochemical parameters, postoperative revision surgery rate, and date of death or last follow-up date were recorded. Pre- and postoperative biological and biochemical parameters, risk of major complications requiring revision surgery and survival time were statistically analyzed.ResultsA total of 105 cats (128 ureters) met the inclusion criteria, consisting of 34 ureters in the stent group, 43 in the SUB group and 51 in the ureterotomy group. There was no significant difference in sex, body weight (BW), serum creatinine, potassium, phosphorus, pH, base excess or packed cell volume (PCV) preoperatively between the three surgical groups. Surgery time and hospitalization duration were significantly longer in the stent group compared with the other two groups. Major complications requiring revision surgeries were 41%, 23%, 15% in the stent, SUB and ureterotomy groups, respectively. The median survival time (MST) was 1426 days in the stent group; MST was not reached in the SUB or ureterotomy groups during the study. Five cats (4.4%; one stent, three SUBs, one ureterotomy) died within 10 days postoperatively. The ureterotomy group had higher long-term PCV and BW.Conclusions and relevanceUreterotomy demonstrated favorable outcomes for the management of feline benign ureteral obstruction, including the lowest rate of revision surgery. Improvements in PCV and BW were most pronounced in this group. In addition, surgical and hospitalization durations were comparable to those of SUB. In this single-center, single-surgeon cohort, these findings support ureterotomy as a viable and durable surgical option in appropriately selected cases, while recognizing that the results may not be generalizable to all clinical settings.