This project was designed to evaluate the comparative efficacy of two different techniques of Ureteroneocystostomy for ureteral reimplantation in dogs. Sixteen stray dogs were selected and were divided into two groups i.e. group A & B, comprising eight animals each. The efficacy of the procedures was evaluated on the basis of physical examination, serum evaluation for creatinine & urea, contrast radiography and post mortem findings.
The surgery was conducted through ventral midline celiotomy from umbilicus to a variable distance caudally under general anesthesia in both the groups and urinary bladder was exteriorized in both the groups. In group A, longitudinal incision was made near the bladder dome, a mosquito hemostat was passed from the surface of the bladder through the bladder wall at an oblique angle then the ureter was brought to the level of the bladder mucosa incision. A 6-0 Polyglactin 910 (Vicyrl,Jhonsons & Jhonsons Pharma) suture with double needles was then placed at each apex of the spatulated ureter and the full-thickness of ureter anastomosed to the bladder mucosa in one layer with a continuous, nonlocking stitch. In group B, two small incisions were made at the outer part of the bladder wall until the mucosa was seen through the cuts. Then a submucosal tunnel was dissected between them and the graft's ureter was introduced. Once the ureteral end has been spatulated, a reabsorbable 4-0 suture thread with independent needles at each end was passed (each needle goes from the outer to the inner side of the ureteral wall. Afterward, both needles were advanced into the bladder by the creation of a mucosal incision at the distal hole; these two needles then transfixed the bladder wall
from inside about 2 cm distally. During knotting of the suture (outside the bladder) the distal ureter was pushed to the bladder wall that it anchored against the mucosa.
The results of this study clearly indicated that both techniques are equally effective for the reimplantation of the ureter to bladder but an extravesical ureteroneocystostomy (Modified Lich Gregoir) has an edge over in intravesical mucosal apposition technique (Modified Lead better-Politano) in terms of effectiveness , safety and minimum postoperative complications.