Equine Urolithiasis: Lithotripsy Versus Surgical Removal

Surgical removal of cystic calculi can be technically challenging mainly in the male horse because of limited access to the bladder and exposure of the bladder. For this reason several surgical techniques for removing cystic calculi have been published in literature, even recently.

Reported surgical approaches are pararectal cystotomy (DeBowes et al. 1984, Van Dongen & Plenderleith 1994, Abuja et al. 2010), perineal urethrotomy (Laverty et al. 1992, Hanson & Poland 1995, Menendez & Fitch 2012), median or parainguinal laparocystotomy (Wright & Neal 1960, Lowe 1961, Williams 1964, Belling 1983, Schäffer 1999, Beard 2004, Russell et al. 2012), laparoscopic intraabdominal techniques (Ragle 1999, 2000, 2002, 2005, Lillich et al. 2006) and laparoscopic-assisted cystotomy techniques (Röcken et al. 2006, Stratico et al. 2012). In addition, a pulse-dye laser and a holmium:YAG laser (Koenig et al. 1999, Judy & Galuppo 2002, Simhofer & Riedelberger 2002) have been used for treatment of urinary calculi in the standing sedated horse, using an ischial urethrotomy. Alternative techniques for mechanical disruption and fragmentation of the calculi have been performed via perineal urethrostomy under general anesthesia (MacHarg et al. 1985, Eustace et al. 1988), or via endoscopically-guided transurethral approach as electrohydraulic (Tschanz & Lischer, Röcken et al. 2008, 2010) or ballistic shockwave lithotripsy in the standing sedated horse (Larry & David 1999).  [...]