Fachbereich Veterinärmedizin



    Endoscopic-assisted electrohydraulic shockwave lithotripsy in standing sedated horses (2012)

    Zeitschriftenartikel / wissenschaftlicher Beitrag
    Röcken, Michael
    Fürst, Anton
    Kummer, Martin
    Mosel, Gesine
    Tschanz, Theo
    Lischer, Christoph J (WE 17)
    Veterinary surgery; 41(5) — S. 620–624
    ISSN: 0161-3499
    DOI: 10.1111/j.1532-950X.2012.00977.x
    Pubmed: 22463076
    Klinik für Pferde, allgemeine Chirurgie und Radiologie

    Oertzenweg 19 b
    14163 Berlin
    +49 30 838 62299

    Abstract / Zusammenfassung

    To report use of transendoscopic electrohydraulic shockwave lithotripsy for fragmentation of urinary calculi in horses.

    Case series.

    Male horses (n = 21).

    Fragmentation of cystic calculi (median, 6 cm diameter; range, 4-11 cm diameter) was achieved by transurethral endoscopy in standing sedated horses using an electrohydraulic shockwave fiber introduced through the biopsy channel of an endoscope. The fiber was advanced until it contacted the calculus. Repeated activation of the fiber was used to disrupt the calculus into fragments <1 cm diameter. Visibility within the bladder was maintained by repeated lavage with saline solution.

    Complete calculus removal was achieved in 20 horses (95%) with mean total surgical time of 168.6 minutes (range, 45-450). In the 20 horses with single calculi, 1-6 sessions were required to completely fragment the calculus. Except for 1 horse, in which perineal urethrotomy was eventually performed for complete fragment removal, fragments calculi were excreted via the urethra. Postoperative complications included hematuria because of severe mucosal erosion (n = 2), dysuria because of a trapped urethral fragment (2), small amount of urinary debris (1). One horse was euthanatized because of bladder rupture. Complete clearance of calculi and urinary debris was confirmed endoscopically 20 (3-45) days after the last session. Telephone follow-up (mean, 18.8 months; range, 7-24 months) revealed that horses had returned to previous activity levels without recurrence of clinical signs.

    Transendoscopic electrohydraulic lithotripsy appears to be an effective method for fragmentation of low-density calcium carbonate cystic calculi in male horses.