Prefemoral cystotomy in 45° dorsolateral recumbency is effective for urolith removal in African spurred tortoises (Centrochelys sulcata).

Prefemoral cystotomy in 45° dorsolateral recumbency effectively removes cystoliths in African spurred tortoises of all sizes.

This retrospective case series describes prefemoral cystotomy performed in 45° dorsolateral recumbency for cystolith removal in African spurred tortoises (Centrochelys sulcata). Eight tortoises from four institutions were treated by a herpetological medicine specialist between May 2017 and May 2025. Patient ages ranged from 3 to over 30 years, with body weights spanning 1.5 to 47.9 kg, demonstrating applicability across a wide size range. Preoperative imaging identified one to three cystoliths per patient, with the longest cystolith diameter measuring 21% to 65% of maximum carapacial width. The 45° dorsolateral positioning provided adequate surgical exposure and enabled successful urolith extraction in all cases. In two cases, a circumferential wound protector/retractor was employed as a conduit into the urinary bladder lumen to minimize celomic contamination. Seven of eight tortoises survived to discharge and through last available follow-up (range: 75–1,081 days postoperatively). Common postoperative findings included inappetence (4/8), decreased urination and defecation (4/8), and reduced activity (3/8). Two cases developed local wound complications: one required debridement for wound dehiscence, and one developed cellulitis that resolved with medical management. No intraoperative fatalities were reported. The authors conclude that prefemoral cystotomy in 45° dorsolateral recumbency is an effective and feasible surgical approach for cystolithiasis in C. sulcata regardless of urolith or patient size, potentially reducing challenges associated with chelonian bladder surgery.

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