Intraoperative urethrocystoscopy reduces operating time and may improve urolith detection during open cystotomy in male dogs over 7 kg.

Objective: To compare the use of intraoperative urethrocystoscopy with postoperative retrograde positive-contrast urethrocystography in male dogs undergoing open cystotomy for urolithiasis and evaluate the efficacy of urethrocystoscopy as an alternative for assessing complete urolith removal.

Methods: This retrospective matched case-control study included 54 male dogs that underwent open cystotomy for urolithiasis between January 2018 and July 2024. Intraoperative urethrocystoscopy was performed in 18 dogs (case group), while postoperative contrast urethrocystography was used in 36 dogs (control group). Completeness of urolith removal and time durations for the 2 techniques were compared.

Results: Both intraoperative urethrocystoscopy and postoperative contrast urethrocystography confirmed complete urolith removal in all dogs. However, 1 control dog presented 50 days postoperatively with a urethral obstruction caused by a retained urolith missed during postoperative imaging. Intraoperative urethrocystoscopy was faster (median, 5.5 minutes; range, 3 to 19 minutes) compared to postoperative imaging (median, 25 minutes; range, 10 to 55 minutes). Intraoperative urethrocystoscopy detected a residual urolith along the urethra in 1 dog, avoiding the need for urethrotomy. No postoperative urethral obstructions occurred in the case group during the follow-up period (median, 374 days; range, 67 to 1,664 days).

Conclusions: Intraoperative urethrocystoscopy was a safe, efficient, and reliable method for confirming complete urolith removal in male dogs undergoing open cystotomy. This technique reduced anesthesia time, avoided additional surgical procedures, and enhanced visualization of the urinary tract.

Clinical relevance: Intraoperative urethrocystoscopy offered a practical and efficient alternative to postoperative contrast imaging for assessing complete urolith removal in male dogs undergoing cystotomy, reducing anesthesia time and potentially decreasing the risk of retained uroliths. Appropriate equipment and training are required to safely perform this technique and minimize the risk of complications.