Subcutaneous ureteral diversion and urethral stenting in the treatment of malignant urinary obstructions in cats: An integrative review of retrospective studies
DOI:
https://doi.org/10.33448/rsd-v14i12.50325Keywords:
Urologic Neoplasms, Ureteral Obstruction, Cats.Abstract
Ureteral obstruction secondary to malignant disease in cats represents a significant clinical challenge due to the rapid progression of renal dysfunction and the aggressive local behavior of urogenital neoplasms. This study aimed to analyze, through an integrative review composed exclusively of retrospective investigations, the clinical outcomes associated with subcutaneous ureteral bypass (SUB) devices and ureteral stents in the management of malignant ureteral obstructions in felines. Methodological procedures included comprehensive extraction of data from seven retrospective studies, focusing on population characteristics, interventions, device patency, complication profiles and renal function outcomes. Findings demonstrated that SUB devices achieved superior long-term patency and functional stability compared to ureteral stents, particularly in cases involving infiltrative transitional cell carcinoma, although late complications such as recurrent urinary infection, partial obstruction and transmural gastrointestinal migration were identified. Ureteral stents, while effective for immediate decompression, exhibited higher rates of tumor-related reobstruction and lower tolerability in the lower urinary tract. Results emphasize that maintenance of device patency and infection control are critical determinants of survival and renal preservation. It is concluded that SUB devices offer superior long-term performance, though clinical decision-making should integrate individual tumor behavior and systemic condition. Future investigations should explore novel biomaterials, imaging-guided monitoring strategies and early predictors of device failure.
References
Berent, A. C., Weisse, C., & Bagley, D. (2020). Interventional management of ureteral obstructions in small animals. Journal of Veterinary Internal Medicine, 34(3), 1203–1221.
Bennett, Z., Lawson, J. S., Chang, Y. M., Shelton, E., Elliott, J., Syme, H. M., & Geddes, R. F. (2025). Progression of chronic kidney disease in cats after subcutaneous ureteral bypass placement compared to cats with idiopathic chronic kidney disease. Journal of Veterinary Internal Medicine, 39, e70242.
Clark, G. N., Giuffrida, M. A., Mayhew, P. D., et al. (2023). Long-term outcomes and complications associated with subcutaneous ureteral bypass devices in cats. Journal of Feline Medicine and Surgery, 25(2), 95–108.
Conze, P., Boller, M., & Berent, A. (2020). Pathophysiology and prognosis of ureteral obstructions in cats. Veterinary Clinics of North America: Small Animal Practice, 50(6), 1201–1220.
Covo, G., Berent, A. C., & Weisse, C. (2024). Clinical outcomes of ureteral and urethral obstruction secondary to transitional cell carcinoma in cats. Journal of Feline Medicine and Surgery.
Fages, J., Darge, A., Bécue, T., et al. (2018). Ultrasonographic changes in renal pelvis and proximal ureter following SUB device placement in cats. Journal of Feline Medicine and Surgery, 20(12), 1154–1163.
Horowitz, C., Berent, A., Weisse, C., et al. (2013). Predictors of outcome for cats with ureteral obstructions after interventional management. Journal of Feline Medicine and Surgery, 15(12), 1052–1062.
Kerr, W. S. (1954). Effects of complete ureteral obstruction for one week on kidney function. Journal of Applied Physiology, 6, 762–766.
Kulendra, E. R., Syme, H. M., Benigni, L., & Halfacree, Z. (2014). Feline double‐pigtail ureteric stents for management of ureteric obstruction: A retrospective evaluation of short‐ and long‐term outcomes in 26 cats. Journal of Feline Medicine and Surgery, 16(12), 985–993.
Kyles, A. E., Hardie, E. M., Wooden, B. G., et al. (2005). Management and outcome of cats with ureteral calculi. Journal of the American Veterinary Medical Association, 226(6), 937–944.
Leibovici, D., Cooper, A., Lindner, A., et al. (2005). Morbidity and impact of ureteral stents on quality of life. Israel Medical Association Journal, 7, 491–494.
Nicoli, S., Morello, E., Martano, M., et al. (2012). Double-J ureteral stenting in nine cats with ureteral obstruction. Veterinary Journal, 194(1), 60–65.
Roberts, S. F., Aronson, L. R., & Brown, D. C. (2011). Postoperative mortality in cats after ureterolithotomy. Veterinary Surgery, 40(4), 438–443.
Sansom, J., & Baines, S. (2021). Diagnosis and management of feline urinary neoplasia. Veterinary Medicine and Science, 7(5), 1533–1545.
Vaden, S. L., & Pressler, B. M. (2022). Chronic kidney disease in small animals: Pathophysiology and management. Veterinary Clinics of North America: Small Animal Practice, 52(1), 1–26.
Véran, E., Vachon, C., Byron, J., Howard, J., Berent, A., Weisse, C., Javard, R., Spencer, A., Gradilla, S., Palm, C., Culp, W., Cléroux, A., & Dunn, M. (2022). Multicenter retrospective evaluation of transmural migration of subcutaneous ureteral bypass devices within the digestive tract in cats. Journal of Veterinary Internal Medicine, 36, 1677–1685.
Vrijsen, N., et al. (2020). Complications and outcome of subcutaneous ureteral bypass placement in cats: A retrospective study of 24 cases. Journal of Feline Medicine and Surgery, 22(4), 362–372.
Wormser, C., Clarke, D. L., Aronson, L. R., et al. (2016). Surgical and interventional management of ureteral obstruction in cats: A retrospective analysis of 117 cases. Journal of the American Veterinary Medical Association, 249(4), 404–413.
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