Study highlights minimally invasive option for canine ectopic ureters: full analysis

CURRENT FULL VERSION: A newly published retrospective case series in the Journal of Small Animal Practice adds 25 dogs to the evidence base for a modified cystoscopic-guided scissor transection technique to treat intramural ureteral ectopia, reporting significant improvement in continence scores with low complication rates. The study positions the approach as another minimally invasive option in a condition where referral clinicians have increasingly moved away from traditional open correction when anatomy is favorable for endoscopic treatment. (pubmed.ncbi.nlm.nih.gov)

That matters because intramural ectopic ureters are a well-recognized cause of lifelong urinary incontinence, especially in female dogs, and these patients often have additional urinary tract abnormalities that complicate diagnosis, prognosis, and post-op expectations. Over the past two decades, cystoscopic-guided laser ablation has become the most established minimally invasive treatment for intramural cases, while open surgical correction has remained necessary for extramural ectopia and select complex presentations. Diagnostic workups have also improved, with ultrasound and advanced CT techniques showing strong utility for screening and defining anatomy before intervention. (pubmed.ncbi.nlm.nih.gov)

The new report appears to expand on a smaller 2022 JAVMA case series that described cystoscopic-guided scissor transection in eight female dogs treated between 2011 and 2020. In that earlier cohort, six of seven dogs with follow-up had immediate continence improvement, three were continent with the procedure alone, three more became continent or markedly improved with added medication, and complications were minor, mainly transient lower urinary tract signs. The authors concluded that scissor transection could be a safe, effective minimally invasive alternative when laser technology isn't available. (pubmed.ncbi.nlm.nih.gov)

The broader comparator literature is important here. In a retrospective evaluation of cystoscopic-guided laser ablation in female dogs, investigators found the technique improved incontinence and produced outcomes similar to prior surgical and endoscopic reports. Earlier JAVMA data on 30 female dogs found that 47% required no additional treatment after laser ablation, while the overall continence rate rose to 77% after adding medical management, bulking-agent injection, or hydraulic occluder placement. Another study of 25 female dogs treated by either open surgery or laser ablation found cystoscopic-guided laser ablation should be preferred when feasible, reflecting lower morbidity and favorable outcomes in intramural cases. (pmc.ncbi.nlm.nih.gov)

Expert-style clinical commentary in the literature has been fairly consistent: minimally invasive correction can be highly useful, but case selection and pet parent counseling are everything. Reviews and referral-center guidance note that not all ectopic ureters are amenable to laser-based correction, and dogs often need ongoing management for residual sphincter incompetence even after technically successful repair. Recent review literature likewise describes minimally invasive surgery as safe and effective, while emphasizing that slight hematuria, cystitis, or persistent incontinence can still occur. (vethospital.tamu.edu)

Why it matters: For veterinarians, this paper may be most relevant as a workflow and access story, not just a technique story. If the modified scissor approach delivers outcomes close to laser ablation, it could lower the equipment barrier for some specialty hospitals and potentially expand treatment availability for pet parents whose dogs are good endoscopic candidates. It also reinforces that success shouldn't be defined too narrowly: for many patients, meaningful improvement in continence, reduced dermatitis risk, and fewer recurrent urinary issues may be clinically valuable even if adjunct medication is still needed. (pubmed.ncbi.nlm.nih.gov)

The study also fits with a larger shift in small animal surgery toward organ-sparing, minimally invasive urinary procedures. That same trend is visible in other contemporary canine urology reports, including laparoscopic and cystoscopic approaches for bladder and ureteral disease, with the goal of reducing morbidity while preserving function when possible. One recent example is a two-dog Veterinary Surgery case series describing laparoscopic stapled partial cystectomy with intraoperative cystourethroscopy for solitary ventral body-to-apical urothelial carcinoma lesions. In those dogs, surgeons used cystoscopic assessment and transillumination to guide 1- to 3-cm gross margins, completed the resection with EndoGIA stapling cartridges, leak-tested the bladder cystoscopically, and reported no intraoperative or short-term complications; histopathology confirmed complete excision in both cases. The authors suggested the closed cystectomy approach may help reduce the risk of peritoneal seeding, while emphasizing that feasibility for non-apical or non-ventral masses still needs study.

For referral teams, the likely next question is comparative: which dogs do just as well with scissors as with laser, and are there meaningful differences in operative time, complication profile, learning curve, or long-term continence? Similar questions apply across minimally invasive urinary oncology and reconstructive procedures: which patients are truly good candidates, and where do early proof-of-concept reports translate into durable clinical advantage? (pubmed.ncbi.nlm.nih.gov)

What to watch: Watch for whether future studies directly compare modified scissor transection with laser ablation in matched intramural cases, and whether centers report cost, training, and equipment implications that could affect adoption. It will also be worth watching whether combined laparoscopic-cystoscopic bladder procedures, such as stapled partial cystectomy for selected non-trigonal urothelial carcinomas, hold up in larger cohorts with longer oncologic follow-up. (pubmed.ncbi.nlm.nih.gov)