Pararectal Cystotomy for Urolith Removal in Nine Horses

Objective: To report outcome of horses after standing pararectal cystotomy for removal of uroliths. Study Design: Case series. Animals: Horses (n=9) with cystic calculi. Methods: Medical records (December 1998–May 2007) of horses with cystic calculi that had standing pararectal cystotomy were reviewed. Signalment; urolith number, size, and type; surgical technique; sedation and analgesia protocols; intra‐ and postoperative complications and outcome were analyzed. Results: Uroliths (mean diameter, 6.37 cm; median, 6 cm; range, 3–10 cm) were removed intact without need for fragmentation. Eight (89%) horses had no complications and 1 horse (11%) developed persistent drainage from the perineal incision and incisional healing was prolonged. The complications resolved after wound revision, and although cystoscopy showed absence of uroliths, the clinical signs associated with cystitis recurred. Conclusions: Cystic calculi can be removed safely in standing horses using a pararectal approach. The procedure was well tolerated and no serious complications were encountered. Clinical Relevance: Pararectal cystotomy allows removal of cystic calculi in standing sedated horses. The technique may offer an economic advantage over approaches that require general anesthesia.