Clinical and surgical approach of a complicated ureter ectopy in a bitch
- Autores
- Escuer, Grisel Elin; Cavilla, María Verónica; Catalano, Clarisa; del Rio, Maria Eugenia; Clausse, María; Catalano, Marcelo Rubén; Nejamkin, Pablo; Landivar, María Florencia; Gutierrez, Maria Verónica; Martínez, Sofía; Nasello, Walter Damian; Fogel, Fernando Adrián; del Sole, Maria Jose
- Año de publicación
- 2021
- Idioma
- inglés
- Tipo de recurso
- documento de conferencia
- Estado
- versión publicada
- Descripción
- Ectopic ureter is a congenital anomaly in which one or both ureters empty out of the bladder. The aim of this work is to describe the clinical findings and the integral treatment performed in a canine with an ectopic ureter. The 5-year-old female Border Collie crossbreed presented urinary incontinence and excessive drooling. At the general inspection, the patient presents a good general condition, hypersalivation due to hypoglossia and ulcerative dermatitis in the groin and vulva due to urine incontinence. An ultrasound study revealed hydroureter of right ureter (62 mm) with a tortuous path, hydronephrosis of the right kidney and left kidney agenesis. A sample was taken for culture and antibiogram. Treatment with enrofloxacin (5 mg / kg orally every 24 h) was indicated based on the result of the culture (Proteus mirabilis ENR sensitive). The opening of the ureter in the urethra was confirmed by excretory urogram and computed tomography. Surgical reimplantation of the urether was carried out 30 days after the initial consultation. During the procedure, active ureteral peristalsis was confirmed. Staphylococcus intermedius and Proteus mirabillis resistant to enrofloxacin were isolated from the urine samples. Therefore, treatment with amoxicillin-clavulanic acid (20 mg / kg orally every 12 h) was indicated. Monthly controls and cultures were repeated. Different microorganisms with multi-resistance were isolated and treatment was indicated. Given the persistence of dilatation of the ureter a ureteropexy was performed 6 months after the initial surgery in the attempt to correct a tortuous course of the ureter distal to the dilatation. To increase ureteral tone, two therapies were implemented: i) treatment with pseudoephedrine (0.23 mg / Kg every 12 h, oral) and ii) weekly physiotherapy with electrical stimulation using exponential monophasic current (Neurovip®). Two months after starting this second treatment, a notable decrease in the diameter of the ureter (52 mm to 19 mm) was observed. These findings were accompanied by a significant reduction in urinary incontinence. However, UTIs recurred for at least 18 months after diagnosis. Throughout the 13 positive cultures, 7 different bacterial strains were isolated: Proteus mirabilis, Staphylococcus intermedius, Morganella morganii, Moraxella urethralis, Oligella urethralis, Enterobacter cloacae, non hemolytic Streptococcus spp. Antibiotic resistance increased as new antibiotic treatments were administered.Management of complicated ureteral ectopic patients is challenging. It is necessary to establish an orderly diagnostic path, correctly select medical and surgical tools for treatment and carry out exhaustive monitoring. In this case, the presence of a single kidney conditioned the treatment since the functionality of the ureter was mandatory. Physiotherapy could be a valuable tool in the treatment of this type of pathology, it would be interesting to further investigate electrical stimulation effect on ureteral motility.
Fil: Escuer, Grisel Elin. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Clinicas. Hospital Escuela; Argentina
Fil: Cavilla, María Verónica. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Clinicas. Hospital Escuela; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Catalano, Clarisa. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Clinicas. Hospital Escuela; Argentina
Fil: del Rio, Maria Eugenia. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Clinicas. Hospital Escuela; Argentina
Fil: Clausse, María. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tandil. Centro de Investigación Veterinaria de Tandil. Universidad Nacional del Centro de la Provincia de Buenos Aires. Centro de Investigación Veterinaria de Tandil. Provincia de Buenos Aires. Gobernación. Comision de Investigaciones Científicas. Centro de Investigación Veterinaria de Tandil; Argentina
Fil: Catalano, Marcelo Rubén. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Clínicas; Argentina
Fil: Nejamkin, Pablo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tandil. Centro de Investigación Veterinaria de Tandil. Universidad Nacional del Centro de la Provincia de Buenos Aires. Centro de Investigación Veterinaria de Tandil. Provincia de Buenos Aires. Gobernación. Comision de Investigaciones Científicas. Centro de Investigación Veterinaria de Tandil; Argentina
Fil: Landivar, María Florencia. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Clinicas. Hospital Escuela; Argentina
Fil: Gutierrez, Maria Verónica. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Clinicas. Hospital Escuela; Argentina
Fil: Martínez, Sofía. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tandil. Centro de Investigación Veterinaria de Tandil. Universidad Nacional del Centro de la Provincia de Buenos Aires. Centro de Investigación Veterinaria de Tandil. Provincia de Buenos Aires. Gobernación. Comision de Investigaciones Científicas. Centro de Investigación Veterinaria de Tandil; Argentina
Fil: Nasello, Walter Damian. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Clinicas. Hospital Escuela; Argentina
Fil: Fogel, Fernando Adrián. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Clínicas; Argentina
Fil: del Sole, Maria Jose. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tandil. Centro de Investigación Veterinaria de Tandil. Universidad Nacional del Centro de la Provincia de Buenos Aires. Centro de Investigación Veterinaria de Tandil. Provincia de Buenos Aires. Gobernación. Comision de Investigaciones Científicas. Centro de Investigación Veterinaria de Tandil; Argentina
1ras. Jornadas del Instituto de Investigaciones Clínicas Veterinarias
Ciudad de Buenos Aires
Argentina
Universidad de Buenos Aires. Facultad de Ciencias Veterinarias - Materia
-
Ureter ectopy
Urinary infection
Dog - Nivel de accesibilidad
- acceso abierto
- Condiciones de uso
- https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
- Repositorio
.jpg)
- Institución
- Consejo Nacional de Investigaciones Científicas y Técnicas
- OAI Identificador
- oai:ri.conicet.gov.ar:11336/161882
Ver los metadatos del registro completo
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Clinical and surgical approach of a complicated ureter ectopy in a bitchEscuer, Grisel ElinCavilla, María VerónicaCatalano, Clarisadel Rio, Maria EugeniaClausse, MaríaCatalano, Marcelo RubénNejamkin, PabloLandivar, María FlorenciaGutierrez, Maria VerónicaMartínez, SofíaNasello, Walter DamianFogel, Fernando Adriándel Sole, Maria JoseUreter ectopyUrinary infectionDoghttps://purl.org/becyt/ford/4.3https://purl.org/becyt/ford/4Ectopic ureter is a congenital anomaly in which one or both ureters empty out of the bladder. The aim of this work is to describe the clinical findings and the integral treatment performed in a canine with an ectopic ureter. The 5-year-old female Border Collie crossbreed presented urinary incontinence and excessive drooling. At the general inspection, the patient presents a good general condition, hypersalivation due to hypoglossia and ulcerative dermatitis in the groin and vulva due to urine incontinence. An ultrasound study revealed hydroureter of right ureter (62 mm) with a tortuous path, hydronephrosis of the right kidney and left kidney agenesis. A sample was taken for culture and antibiogram. Treatment with enrofloxacin (5 mg / kg orally every 24 h) was indicated based on the result of the culture (Proteus mirabilis ENR sensitive). The opening of the ureter in the urethra was confirmed by excretory urogram and computed tomography. Surgical reimplantation of the urether was carried out 30 days after the initial consultation. During the procedure, active ureteral peristalsis was confirmed. Staphylococcus intermedius and Proteus mirabillis resistant to enrofloxacin were isolated from the urine samples. Therefore, treatment with amoxicillin-clavulanic acid (20 mg / kg orally every 12 h) was indicated. Monthly controls and cultures were repeated. Different microorganisms with multi-resistance were isolated and treatment was indicated. Given the persistence of dilatation of the ureter a ureteropexy was performed 6 months after the initial surgery in the attempt to correct a tortuous course of the ureter distal to the dilatation. To increase ureteral tone, two therapies were implemented: i) treatment with pseudoephedrine (0.23 mg / Kg every 12 h, oral) and ii) weekly physiotherapy with electrical stimulation using exponential monophasic current (Neurovip®). Two months after starting this second treatment, a notable decrease in the diameter of the ureter (52 mm to 19 mm) was observed. These findings were accompanied by a significant reduction in urinary incontinence. However, UTIs recurred for at least 18 months after diagnosis. Throughout the 13 positive cultures, 7 different bacterial strains were isolated: Proteus mirabilis, Staphylococcus intermedius, Morganella morganii, Moraxella urethralis, Oligella urethralis, Enterobacter cloacae, non hemolytic Streptococcus spp. Antibiotic resistance increased as new antibiotic treatments were administered.Management of complicated ureteral ectopic patients is challenging. It is necessary to establish an orderly diagnostic path, correctly select medical and surgical tools for treatment and carry out exhaustive monitoring. In this case, the presence of a single kidney conditioned the treatment since the functionality of the ureter was mandatory. Physiotherapy could be a valuable tool in the treatment of this type of pathology, it would be interesting to further investigate electrical stimulation effect on ureteral motility.Fil: Escuer, Grisel Elin. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Clinicas. Hospital Escuela; ArgentinaFil: Cavilla, María Verónica. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Clinicas. Hospital Escuela; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Catalano, Clarisa. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Clinicas. Hospital Escuela; ArgentinaFil: del Rio, Maria Eugenia. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Clinicas. Hospital Escuela; ArgentinaFil: Clausse, María. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tandil. Centro de Investigación Veterinaria de Tandil. Universidad Nacional del Centro de la Provincia de Buenos Aires. Centro de Investigación Veterinaria de Tandil. Provincia de Buenos Aires. Gobernación. Comision de Investigaciones Científicas. Centro de Investigación Veterinaria de Tandil; ArgentinaFil: Catalano, Marcelo Rubén. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Clínicas; ArgentinaFil: Nejamkin, Pablo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tandil. Centro de Investigación Veterinaria de Tandil. Universidad Nacional del Centro de la Provincia de Buenos Aires. Centro de Investigación Veterinaria de Tandil. Provincia de Buenos Aires. Gobernación. Comision de Investigaciones Científicas. Centro de Investigación Veterinaria de Tandil; ArgentinaFil: Landivar, María Florencia. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Clinicas. Hospital Escuela; ArgentinaFil: Gutierrez, Maria Verónica. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Clinicas. Hospital Escuela; ArgentinaFil: Martínez, Sofía. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tandil. Centro de Investigación Veterinaria de Tandil. Universidad Nacional del Centro de la Provincia de Buenos Aires. Centro de Investigación Veterinaria de Tandil. Provincia de Buenos Aires. Gobernación. Comision de Investigaciones Científicas. Centro de Investigación Veterinaria de Tandil; ArgentinaFil: Nasello, Walter Damian. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Clinicas. Hospital Escuela; ArgentinaFil: Fogel, Fernando Adrián. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Clínicas; ArgentinaFil: del Sole, Maria Jose. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tandil. Centro de Investigación Veterinaria de Tandil. Universidad Nacional del Centro de la Provincia de Buenos Aires. Centro de Investigación Veterinaria de Tandil. Provincia de Buenos Aires. Gobernación. Comision de Investigaciones Científicas. Centro de Investigación Veterinaria de Tandil; Argentina1ras. Jornadas del Instituto de Investigaciones Clínicas VeterinariasCiudad de Buenos AiresArgentinaUniversidad de Buenos Aires. Facultad de Ciencias VeterinariasUniversidad de Buenos Aires. Facultad de Ciencias Veterinarias2021info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/conferenceObjectJornadaJournalhttp://purl.org/coar/resource_type/c_5794info:ar-repo/semantics/documentoDeConferenciaapplication/pdfapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentapplication/pdfhttp://hdl.handle.net/11336/161882Clinical and surgical approach of a complicated ureter ectopy in a bitch; 1ras. 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| dc.title.none.fl_str_mv |
Clinical and surgical approach of a complicated ureter ectopy in a bitch |
| title |
Clinical and surgical approach of a complicated ureter ectopy in a bitch |
| spellingShingle |
Clinical and surgical approach of a complicated ureter ectopy in a bitch Escuer, Grisel Elin Ureter ectopy Urinary infection Dog |
| title_short |
Clinical and surgical approach of a complicated ureter ectopy in a bitch |
| title_full |
Clinical and surgical approach of a complicated ureter ectopy in a bitch |
| title_fullStr |
Clinical and surgical approach of a complicated ureter ectopy in a bitch |
| title_full_unstemmed |
Clinical and surgical approach of a complicated ureter ectopy in a bitch |
| title_sort |
Clinical and surgical approach of a complicated ureter ectopy in a bitch |
| dc.creator.none.fl_str_mv |
Escuer, Grisel Elin Cavilla, María Verónica Catalano, Clarisa del Rio, Maria Eugenia Clausse, María Catalano, Marcelo Rubén Nejamkin, Pablo Landivar, María Florencia Gutierrez, Maria Verónica Martínez, Sofía Nasello, Walter Damian Fogel, Fernando Adrián del Sole, Maria Jose |
| author |
Escuer, Grisel Elin |
| author_facet |
Escuer, Grisel Elin Cavilla, María Verónica Catalano, Clarisa del Rio, Maria Eugenia Clausse, María Catalano, Marcelo Rubén Nejamkin, Pablo Landivar, María Florencia Gutierrez, Maria Verónica Martínez, Sofía Nasello, Walter Damian Fogel, Fernando Adrián del Sole, Maria Jose |
| author_role |
author |
| author2 |
Cavilla, María Verónica Catalano, Clarisa del Rio, Maria Eugenia Clausse, María Catalano, Marcelo Rubén Nejamkin, Pablo Landivar, María Florencia Gutierrez, Maria Verónica Martínez, Sofía Nasello, Walter Damian Fogel, Fernando Adrián del Sole, Maria Jose |
| author2_role |
author author author author author author author author author author author author |
| dc.subject.none.fl_str_mv |
Ureter ectopy Urinary infection Dog |
| topic |
Ureter ectopy Urinary infection Dog |
| purl_subject.fl_str_mv |
https://purl.org/becyt/ford/4.3 https://purl.org/becyt/ford/4 |
| dc.description.none.fl_txt_mv |
Ectopic ureter is a congenital anomaly in which one or both ureters empty out of the bladder. The aim of this work is to describe the clinical findings and the integral treatment performed in a canine with an ectopic ureter. The 5-year-old female Border Collie crossbreed presented urinary incontinence and excessive drooling. At the general inspection, the patient presents a good general condition, hypersalivation due to hypoglossia and ulcerative dermatitis in the groin and vulva due to urine incontinence. An ultrasound study revealed hydroureter of right ureter (62 mm) with a tortuous path, hydronephrosis of the right kidney and left kidney agenesis. A sample was taken for culture and antibiogram. Treatment with enrofloxacin (5 mg / kg orally every 24 h) was indicated based on the result of the culture (Proteus mirabilis ENR sensitive). The opening of the ureter in the urethra was confirmed by excretory urogram and computed tomography. Surgical reimplantation of the urether was carried out 30 days after the initial consultation. During the procedure, active ureteral peristalsis was confirmed. Staphylococcus intermedius and Proteus mirabillis resistant to enrofloxacin were isolated from the urine samples. Therefore, treatment with amoxicillin-clavulanic acid (20 mg / kg orally every 12 h) was indicated. Monthly controls and cultures were repeated. Different microorganisms with multi-resistance were isolated and treatment was indicated. Given the persistence of dilatation of the ureter a ureteropexy was performed 6 months after the initial surgery in the attempt to correct a tortuous course of the ureter distal to the dilatation. To increase ureteral tone, two therapies were implemented: i) treatment with pseudoephedrine (0.23 mg / Kg every 12 h, oral) and ii) weekly physiotherapy with electrical stimulation using exponential monophasic current (Neurovip®). Two months after starting this second treatment, a notable decrease in the diameter of the ureter (52 mm to 19 mm) was observed. These findings were accompanied by a significant reduction in urinary incontinence. However, UTIs recurred for at least 18 months after diagnosis. Throughout the 13 positive cultures, 7 different bacterial strains were isolated: Proteus mirabilis, Staphylococcus intermedius, Morganella morganii, Moraxella urethralis, Oligella urethralis, Enterobacter cloacae, non hemolytic Streptococcus spp. Antibiotic resistance increased as new antibiotic treatments were administered.Management of complicated ureteral ectopic patients is challenging. It is necessary to establish an orderly diagnostic path, correctly select medical and surgical tools for treatment and carry out exhaustive monitoring. In this case, the presence of a single kidney conditioned the treatment since the functionality of the ureter was mandatory. Physiotherapy could be a valuable tool in the treatment of this type of pathology, it would be interesting to further investigate electrical stimulation effect on ureteral motility. Fil: Escuer, Grisel Elin. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Clinicas. Hospital Escuela; Argentina Fil: Cavilla, María Verónica. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Clinicas. Hospital Escuela; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Catalano, Clarisa. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Clinicas. Hospital Escuela; Argentina Fil: del Rio, Maria Eugenia. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Clinicas. Hospital Escuela; Argentina Fil: Clausse, María. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tandil. Centro de Investigación Veterinaria de Tandil. Universidad Nacional del Centro de la Provincia de Buenos Aires. Centro de Investigación Veterinaria de Tandil. Provincia de Buenos Aires. Gobernación. Comision de Investigaciones Científicas. Centro de Investigación Veterinaria de Tandil; Argentina Fil: Catalano, Marcelo Rubén. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Clínicas; Argentina Fil: Nejamkin, Pablo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tandil. Centro de Investigación Veterinaria de Tandil. Universidad Nacional del Centro de la Provincia de Buenos Aires. Centro de Investigación Veterinaria de Tandil. Provincia de Buenos Aires. Gobernación. Comision de Investigaciones Científicas. Centro de Investigación Veterinaria de Tandil; Argentina Fil: Landivar, María Florencia. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Clinicas. Hospital Escuela; Argentina Fil: Gutierrez, Maria Verónica. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Clinicas. Hospital Escuela; Argentina Fil: Martínez, Sofía. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tandil. Centro de Investigación Veterinaria de Tandil. Universidad Nacional del Centro de la Provincia de Buenos Aires. Centro de Investigación Veterinaria de Tandil. Provincia de Buenos Aires. Gobernación. Comision de Investigaciones Científicas. Centro de Investigación Veterinaria de Tandil; Argentina Fil: Nasello, Walter Damian. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Clinicas. Hospital Escuela; Argentina Fil: Fogel, Fernando Adrián. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de Ciencias Veterinarias. Departamento de Clínicas; Argentina Fil: del Sole, Maria Jose. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tandil. Centro de Investigación Veterinaria de Tandil. Universidad Nacional del Centro de la Provincia de Buenos Aires. Centro de Investigación Veterinaria de Tandil. Provincia de Buenos Aires. Gobernación. Comision de Investigaciones Científicas. Centro de Investigación Veterinaria de Tandil; Argentina 1ras. Jornadas del Instituto de Investigaciones Clínicas Veterinarias Ciudad de Buenos Aires Argentina Universidad de Buenos Aires. Facultad de Ciencias Veterinarias |
| description |
Ectopic ureter is a congenital anomaly in which one or both ureters empty out of the bladder. The aim of this work is to describe the clinical findings and the integral treatment performed in a canine with an ectopic ureter. The 5-year-old female Border Collie crossbreed presented urinary incontinence and excessive drooling. At the general inspection, the patient presents a good general condition, hypersalivation due to hypoglossia and ulcerative dermatitis in the groin and vulva due to urine incontinence. An ultrasound study revealed hydroureter of right ureter (62 mm) with a tortuous path, hydronephrosis of the right kidney and left kidney agenesis. A sample was taken for culture and antibiogram. Treatment with enrofloxacin (5 mg / kg orally every 24 h) was indicated based on the result of the culture (Proteus mirabilis ENR sensitive). The opening of the ureter in the urethra was confirmed by excretory urogram and computed tomography. Surgical reimplantation of the urether was carried out 30 days after the initial consultation. During the procedure, active ureteral peristalsis was confirmed. Staphylococcus intermedius and Proteus mirabillis resistant to enrofloxacin were isolated from the urine samples. Therefore, treatment with amoxicillin-clavulanic acid (20 mg / kg orally every 12 h) was indicated. Monthly controls and cultures were repeated. Different microorganisms with multi-resistance were isolated and treatment was indicated. Given the persistence of dilatation of the ureter a ureteropexy was performed 6 months after the initial surgery in the attempt to correct a tortuous course of the ureter distal to the dilatation. To increase ureteral tone, two therapies were implemented: i) treatment with pseudoephedrine (0.23 mg / Kg every 12 h, oral) and ii) weekly physiotherapy with electrical stimulation using exponential monophasic current (Neurovip®). Two months after starting this second treatment, a notable decrease in the diameter of the ureter (52 mm to 19 mm) was observed. These findings were accompanied by a significant reduction in urinary incontinence. However, UTIs recurred for at least 18 months after diagnosis. Throughout the 13 positive cultures, 7 different bacterial strains were isolated: Proteus mirabilis, Staphylococcus intermedius, Morganella morganii, Moraxella urethralis, Oligella urethralis, Enterobacter cloacae, non hemolytic Streptococcus spp. Antibiotic resistance increased as new antibiotic treatments were administered.Management of complicated ureteral ectopic patients is challenging. It is necessary to establish an orderly diagnostic path, correctly select medical and surgical tools for treatment and carry out exhaustive monitoring. In this case, the presence of a single kidney conditioned the treatment since the functionality of the ureter was mandatory. Physiotherapy could be a valuable tool in the treatment of this type of pathology, it would be interesting to further investigate electrical stimulation effect on ureteral motility. |
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2021 |
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1846082908935159808 |
| score |
13.22299 |