Ureterotomy in Dogs

A ureterotomy is a surgical incision into the ureter. The ureter is the duct that carries urine from the kidneys to the bladder. If blockages occur in the ureter or the ureter is displaced due to surgical intervention, trauma, or congenital abnormalities, it will need to be incised with a ureterotomy to remove blockage, or prior to ureteroneocystostomy to reconnect the ureter to the bladder. This procedure requires a veterinary surgeon with specialized training in urological system surgical procedures, and is performed under general anesthetic in dogs requiring this type of intervention.

Prior to surgery, your dog will be required to fast from food for 12 hours. General anaesthetic by intubation and gas will be administered after your dog has been sedated and administered intravenous anesthetic to put them into a deep sleep. The pelvic area will be shaved and prepared antiseptically for an incision. Urinary catheters will be placed to drain urine. The ureter will be isolated and care taken not to interfere with other tissues in the area. Due to the delicacy of the structure, an operating microscope is used to perform ureterotomy in many cases. An alternative is to dilate the ureter so that the procedure can be performed with surgical magnifying devices. A longitudinal incision is made into the ureter proximal to the blockages and blockages carefully removed. Suture repairs are made with to the incision in the ureter. Your dog’s pelvic wall incision will be closed with sutures and your dog will be monitored during recovery from anesthetic.

Ureterotomy resolves blockages in a more timely manner than intervention with medication to dissolve blockages. Although urinary incontinence can still occur, medication such as phenylpropanolamine to address this can be prescribed with good success. 

Analgesics and antibiotics will be prescribed for a few days and should be administered as directed. Urinary incontinence can be expected during recovery and should resolve in many cases. Monitoring of fluid intake and output to ensure that your dog's urinary and renal systems are recovering functioning will need to occur. Your dog will need to have activity restricted for several days post surgery. The surgical incision should be monitored to ensure there is no redness, discharge, excessive swelling or bleeding at the site. If this occurs, veterinary advice should be obtained. You will need to prevent your dog from interfering with the incision and an E-collar will usually be used. A specialized diet may be recommended to support urinary tract function in your dog on an ongoing basis, to prevent further blockages in the ureter and other urinary tract structures.

Because this procedure is very delicate and requires specialized magnifying surgical equipment and training by your veterinary surgeon, the cost can range from $1,000 to $5,000. Cost varies depending on your location, your dog's medical condition, and availability of a veterinarian specialist equipped to perform this procedure.

Ureterotomy complications can include continued urinary incontinence. Also dehiscence or stricture at the repair site on the ureter can occur, resulting in complications such as urine leaks causing uroperitoneum, where urine leaks into the peritoneal cavity. Surgical intervention by a specialized veterinary surgeon with training in urinary tract surgical procedures mitigates the chance of these complications occurring.

General anesthetic administration, hemorrhage and infection are also risks present with surgical interventions.

Feeding your dog a diet specially designed for dogs with urinary tract issues, that is low in minerals and substances that could build up in the urinary tract, is recommended for prevention of blockages in the ureter. Additionally, making sure your dog always has an adequate supply of fresh water to stay hydrated and ensure that urine does not become concentrated in the urinary tract will reduce the likelihood of sediment buildup and blockage in the ureters.

For dogs whom blockages are a chronic problem, checking urine pH regularly and adjusting fluid intake and diet as required may be useful in preventing blockage recurrences.