Surgical Correction of a Vesicourachal Diverticulum in a Cat

고양이에서 방광요막관 게실의 외과적 치료 증례

  • Yoon, Hun-Young (Department of Veterinary Surgery, College of Veterinary Medicine and the Veterinary Science Research Institute, Konkuk University) ;
  • Roh, Mi-Young (Duckso Animal Hospital) ;
  • Jeong, Soon-Wuk (Department of Veterinary Surgery, College of Veterinary Medicine and the Veterinary Science Research Institute, Konkuk University)
  • 윤헌영 (건국대학교 수의과대학 수의외과학 교실, 수의과학 연구소) ;
  • 노미영 (덕소 동물병원) ;
  • 정순욱 (건국대학교 수의과대학 수의외과학 교실, 수의과학 연구소)
  • Accepted : 2012.12.18
  • Published : 2012.12.31

Abstract

A 4-year-old female Korean short hair cat weighing 6.5 kg presented for evaluation of urinary incontinence and stranguria. On physical examination, stranguria was observed concurrently with urinary bladder distention. Abdominal radiographs revealed two small uroliths in the urinary bladder. Urinary bladder sludge was detected on abdominal ultrasound. Urine analysis indicated hematuria and bacteriuria. The cat was treated with a 4-week course of a combination of antibiotics and urinary bladder irrigation using normal saline; however, response to treatment was minimal. Excretory urography was performed to identify a congenital disorder. A small diverticulum, located to the urinary bladder apex, was identified. A tentative diagnosis of a vesicourachal diverticulum was made. Surgical exploration of the abdomen was performed and a triangular-shaped diverticulum was apparent at the urinary bladder apex. Cystotomy was performed to remove two small uroliths. Partial cystectomy was then performed for diverticulectomy. Approximately 2 cm diameter of a part of the apex was removed. Normal urination was regained 5 days postoperatively. The follow-up was completed by physical examination 2 years after surgery. There was no evidence of stranguria and urinary incontinence.

암컷, 4년령, 6.5 kg의 단모종 고양이가 배뇨실금 및 배뇨곤란 증상을 주증으로 내원하였다. 신체 검사에서 방광 팽창을 동반한 배뇨곤란 증상을 확인 하였고, 방사선 검사와 초음파 검사에서 2개의 작은 방광 결석과 방광내 슬러지를 각각 확인 하였다. 소변 검사에서 혈뇨와 세균뇨를 확인 하였다. 식염수를 이용한 방광 세척과 항생제 치료를 4주간 실시 하였으나 치료 효과가 미미하였다. 선천적 이상을 확인하기 위해 배설성 요로조영술을 실시하였고, 작은 게실이 방광 앞쪽 끝에서 관찰 되었다. 방광요막관 게실이 의심 되어 탐색적 개복술을 실시 하였고 삼각형 모양의 게실이 방광 앞쪽 끝에서 확인 되었다. 방광 결석 제거를 위해 방광 절개술이 실시 되었고 게실 절제를 위해 방광 부분 절제술이 실시 되었다. 방광 앞쪽 끝 부분을 지름 약 2 cm 정도 절제 하였다. 수술 후 5일 째 정상 배뇨가 가능하였다. 수술 후 정기 검진은 신체 검사를 통해 2년 동안 실시 되었으며 배뇨 곤란과 배뇨 실금 증상이 관찰 되지 않았다.

Keywords

References

  1. Birchard SJ. Surgery of the urinary bladder. In: Saunders manual of small animal practice. Philadelphia: Saunders. 1994:837-848.
  2. Cote E. Urachal diverticulum. In: Clinical veterinary advisor: dogs and cats. St. Louis: Mosby Elsevier. 2007: 1117-1118.
  3. Ettinger SJ, Feldman EC. Canine lower urinary tract disease. In: Textbook of veterinary internal medicine, 6th ed. St. Louis: Elsevier Saunders. 2005: 1850-1874.
  4. Groesslinger K, Tham T, Egerbacher M, Lorinson D. Prevalence and radiologic and histologic appearance of vesicourachal diverticula in dogs without clinical signs of urinary tract disease. J Am Vet Med Assoc 2005; 226: 383-386. https://doi.org/10.2460/javma.2005.226.383
  5. Haburjak JJ, Markoff BF. What is your diagnosis? Vesicourachal diverticulum. J Small Anim Pract 2001; 42: 200-201 https://doi.org/10.1111/j.1748-5827.2001.tb01803.x
  6. Hansen JS. Urachal remnant in the cat: occurrence and relationship to the feline urological syndrome. Vet Med Small Anim Clin 1977; 72: 1735-1746.
  7. Lulich JP, Osborne CA, Johnston GR. Non-surgical correction of infection-induced struvite uroliths and vesicourachal diverticulum in an immature dog. J Small Anim Pract 1989;30: 613-617. https://doi.org/10.1111/j.1748-5827.1989.tb01489.x
  8. Osborne CA, Johnston GR, Kruger JM, O'Brien TD, Lulich JP. Etiopathogenesis and biological behavior of feline vesicourachal diverticula. Vet Clin North Am 1987; 17: 697-734. https://doi.org/10.1016/S0195-5616(87)50060-2
  9. Slatter D. Urinary Bladder. In: Textbook of small animal surgery, 3rd ed. Philadelphia: Saunders. 2003: 1629-1637.
  10. Yu JS, Kim KW, Lee HJ, Lee YJ, Yoon CS, Kim KJ. Urachal remnant disease: spectrum of CT and US findings. Radiographics 2001; 21: 451-461. https://doi.org/10.1148/radiographics.21.2.g01mr02451