Cystotomy

Urinary catheter placed pre-operativelyUrinary catheter placed pre-operativelySince urethral surgery is more technically demanding and can lead to postoperative stricture formation, urethral calculi are first retropulsed into the urinary bladder and removed by cystotomy. A urinary catheter is typically maintained after retropulsion to prevent any calculi from returning to a urethral position prior to removal.
 

 

Most cystotomies are performed through a caudal abdominal midline incision that extends from caudal to the umbilicus to the level of the pubis. After entering the abdominal cavity, identify the urinary bladder, exteriorize it by placing stay sutures (which will facilitate atraumatic tissue handling) and pack off the urinary bladder with moist laparotomy sponges to prevent abdominal contamination. If the bladder is full, drain it with a syringe and needle (aimed from the apex towards the trigone), with suction and a needle, or collect any spillage with sponges or suction at the time of cystotomy.