Ureteroneocystostomy as a treatment for benign ureteral obstruction and ectopic ureter in cats: 37 cases

To report complications and outcomes following ureteroneocystostomy performed in cats presenting for benign ureteral obstruction or ectopic ureters.

This was a retrospective, single-institution study of 37 cats. Medical records were reviewed for pre-, intra-, and postoperative variables including preexisting disease, pre- and postoperative bloodwork, location and source of obstruction, surgical technique, ureteral stent placement, postoperative clinical signs, and survival time. Follow-up was ≥ 14 days or until death. The Kaplan-Meier method was used to calculate median survival, and univariable and multivariable logistic regression was used to examine correlation of variables with postoperative complications and mortality.

Overall median survival was 1,980 days, with 92% of cats surviving to discharge. There was no intraoperative mortality and a relatively low incidence of short- (19%) and long-term (24%) complications. Highest mortality rate was within the first 30 days. Factors associated with increased mortality were increased preoperative BUN, creatinine, and phosphorous. Surgical ureteral stent removal occurred in 86% (6 of 7) of cases when placed, secondary to long-term recurrent urinary tract infections and stent migration.

Ureteroneocystostomy was a viable treatment option for benign obstructions and extramural ectopic ureters in cats, with overall longer median survival and lower long-term complication incidence compared to historical subcutaneous ureteral bypass device and ureteral stent literature. Preoperative azotemia was associated with poorer outcomes. Ureteral stents were associated with long-term complications, prompting removal.

Ureteroneocystostomy should be highly considered as a treatment option for cats presenting with benign ureteral obstructions and ectopic ureters.