Tailored ureteroneocystostomy with tension-relieving techniques for benign ureteral obstruction in cats: a retrospective study of 189 cases (220 ureters).

Tailored ureteroneocystostomy with tension-relief techniques is optimal for feline ureteral obstruction.

This retrospective study evaluates surgical techniques for ureteroneocystostomy in 189 cats (220 ureters) with benign ureteral obstruction treated between 2018-2024. The study compared four ureteroneocystostomy techniques and conducted meta-analyses comparing outcomes with subcutaneous ureteral bypass, ureteral stents, and traditional surgical approaches. Overall perioperative mortality was 0.5%, uroabdomen rate 1.1%, reobstruction rate 8.5%, and urinary tract infection rate 13.2%. The 12-month survival rate was 89.4%. Cats with IRIS chronic kidney disease stage ≥III at one month postoperatively had significantly shorter survival times. Extravesicular, two-layer, side-to-side ureteroneocystostomy with tension-relieving techniques demonstrated the lowest reobstruction risk compared to other techniques. Results were similar to or superior to implant-based and traditional surgical approaches. The authors conclude that tailored ureteroneocystostomy combined with tension-relieving techniques and temporary ureteral catheterization represents optimal primary surgical management for feline benign ureteral obstruction, offering favorable long-term outcomes and low complication rates.

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