Ureteronephrectomy

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Sections available in full article Introduction, Uses, Alternative techniques, Time required, Decision taking, Requirements, Materials required, Preparation, Procedure, Aftercare, Immediate Aftercare, Sequelae, Complications, Prognosis, Sources, Publications, Vetstream contributor(s),
Contributors Dr Dick White BVetMed PhD DSAS DVR FRCVS DipACVS DipECVS RCVS, ACVS and European Recognised Specialist in Small Animal Surgery RCVS Recognised Specialist in Veterinary Oncology
Dr Lori Ludwig DVM DipACVS

Introduction

  • Removal of ureter and kidney.

Uses

  • Gross trauma, eg crush injury, avulsion.
  • Neoplastic lesions.
  • Ectopic ureter Ureter: ectopic , hydronephrosis Hydronephrosis hydroureter.
  • Cysts: solitary or multiple Kidney: polycystic disease.
  • Idiopathic renal hematuria.
  • Dioctophyma renale.
  • Pyelonephritis Pyelonephritis.

Advantages

  • Relatively straightforward.

Disadvantages

  • Must ensure that contralateral kidney function is normal.

Preparation

  • Perform intravenous pyelography or scintigraphy Scintigraphy: renal for GFR prior to surgery to confirm function of other kidney. Perform day before surgery.

Requirements

Materials required

Minimum equipment

  • Standard laparotomy kit.

Ideal equipment

  • Abdominal retractors, eg Gossett or Balfour Surgical instruments: self-retaining retractors - Balfour abdominal.

Minimum consumables

  • Suture material, eg 3 metric silk or vicryl. Standard laparatomy pack - Balfours, Metzenbaum scissors.

Sequelae

Complications

  • Relate to surgical technique (risk of hemorrhage) and to function of remaining kidney.

Prognosis

  • Arteriovenous fistula if artery and vein ligated together.
  • Depends on underlying disease.
  • Can expect normal quality of life if remaining kidney has normal function and no underlying disease process.

Sources

Publications

  • Gookin J L et al(1996) Unilateral nephrectomy in dogs with renal disease - 30 cases (1985 - 1994). JAVMA 208 , 2020.
  • Lirtzmann R A & Gregory C R (1995) Long-term renal and hematologic effects of uninephrectomy in healthy feline kidney donors. JAVMA 207 , 1044.
  • Christie B A (1980) Collateral arterial blood supply to the normal ischemic canine kidney. Am J Vet Res 41 , 1519.
  • Chew Q T & Madayag M A (1973) Post-nephrectomy arteriovenous fistula. J Urol 109 , 546.

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