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Adair et al: Retrospective comparison of modified percutaneous cystolithotomy (PCCLm) and traditional open cystotomy (OC) in dogs: 218 cases (2010–2019)
Veterinary Surgery 6, 2023

🔍 Key Findings

  • PCCLm resulted in significantly fewer postoperative lower urinary tract signs compared to OC (13.0% vs 60.9%, p <.001).
  • Incomplete urolith removal was not significantly different between PCCLm and OC (11.4% vs 20%, p = .112).
  • PCCLm had significantly shorter anesthesia times than OC when no concurrent procedures were performed (97.5 vs 120 min, p < .001).
  • Surgical site infection/inflammation (SSII) rates were low and not significantly different between groups (4.5% PCCLm vs 1.8% OC).
  • Dogs undergoing PCCLm were more frequently discharged same-day (84.7% vs 0% in OC), reflecting faster recovery.
  • PCCLm had higher intraoperative complication rates (22.1% vs 3.4%), mostly due to incision extension or conversions.
  • Time to additional surgery for urolith recurrence was longer in PCCLm dogs (24 vs 11.5 months, p = .004).
  • Calcium oxalate uroliths were more prevalent in PCCLm cases, while OC had more struvite or mixed types.

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← Articles

Adair et al: Retrospective comparison of modified percutaneous cystolithotomy (PCCLm) and traditional open cystotomy (OC) in dogs: 218 cases (2010–2019)
Veterinary Surgery 6, 2023

🔍 Key Findings

  • PCCLm resulted in significantly fewer postoperative lower urinary tract signs compared to OC (13.0% vs 60.9%, p <.001).
  • Incomplete urolith removal was not significantly different between PCCLm and OC (11.4% vs 20%, p = .112).
  • PCCLm had significantly shorter anesthesia times than OC when no concurrent procedures were performed (97.5 vs 120 min, p < .001).
  • Surgical site infection/inflammation (SSII) rates were low and not significantly different between groups (4.5% PCCLm vs 1.8% OC).
  • Dogs undergoing PCCLm were more frequently discharged same-day (84.7% vs 0% in OC), reflecting faster recovery.
  • PCCLm had higher intraoperative complication rates (22.1% vs 3.4%), mostly due to incision extension or conversions.
  • Time to additional surgery for urolith recurrence was longer in PCCLm dogs (24 vs 11.5 months, p = .004).
  • Calcium oxalate uroliths were more prevalent in PCCLm cases, while OC had more struvite or mixed types.

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Multiple Choice Questions on this study

In Adair 2023 et al., on PCCLm vs. open cystotomy, what was a statistically significant long-term difference in outcomes?

A. Higher recurrence rate in OC group
B. Lower mortality in PCCLm group
C. More reoperations in PCCLm group
D. Shorter time to death in OC group
E. No difference in long-term outcomes

Answer: Shorter time to death in OC group

Explanation: OC group had significantly shorter median time to death postoperatively (17 vs. 46 months).
In Adair 2023 et al., on PCCLm vs. open cystotomy, what factor was associated with an increased risk of residual uroliths postoperatively in both groups?

A. Stone diameter >15 mm
B. Concurrent infection
C. Calcium oxalate composition
D. Uroliths too numerous to count
E. Previous urinary surgery

Answer: Uroliths too numerous to count

Explanation: "Uroliths too numerous to count" was significantly associated with incomplete removal in both groups.
In Adair 2023 et al., on PCCLm vs. open cystotomy, what outcome was significantly more common in the open cystotomy group postoperatively?

A. Increased surgical time
B. Faster recovery
C. Shorter anesthesia
D. Reduced lower urinary tract signs
E. Increased lower urinary tract signs

Answer: Increased lower urinary tract signs

Explanation: OC group showed significantly more postoperative LUT signs than PCCLm group (60.9% vs. 13.0%).
In Adair 2023 et al., on PCCLm vs. open cystotomy, what factor increased the odds of surgical site infection/inflammation in the PCCLm group?

A. Incomplete stone removal
B. Concurrent urinary tract infection
C. Bladder wall trauma
D. Incision extension for exposure
E. Obesity

Answer: Incision extension for exposure

Explanation: Incision extension (not for other procedures) increased SSII risk (OR 18.76, p = .027).
In Adair 2023 et al., on PCCLm vs. open cystotomy, what was the most common reason for converting PCCLm to OC?

A. Intraoperative hemorrhage
B. Intra-abdominal adhesions
C. Difficulty with visualization
D. Too numerous stones to retrieve with cystoscope
E. Unexpected bladder rupture

Answer: Too numerous stones to retrieve with cystoscope

Explanation: Most PCCLm to OC conversions (4/5) were due to difficulty retrieving numerous stones.
In Adair 2023 et al., on PCCLm vs OC in dogs, what was the most statistically significant short-term benefit observed with PCCLm?

A. Reduced surgery time
B. Lower anesthesia drug use
C. Shorter hospitalization stay
D. Lower rate of lower urinary tract signs
E. Fewer urethral stones

Answer: Lower rate of lower urinary tract signs

Explanation: Postoperative lower urinary tract signs were significantly less frequent in PCCLm dogs (13.0% vs 60.9%).
In Adair 2023 et al., on PCCLm vs OC in dogs, which complication was significantly associated with PCCLm incision extension?

A. Splenic hemorrhage
B. Urolith recurrence
C. Conversion to OC
D. Surgical site infection/inflammation (SSII)
E. Incomplete stone removal

Answer: Surgical site infection/inflammation (SSII)

Explanation: SSII was significantly associated with incision extension in PCCLm cases (OR = 18.76, p = .027).
In Adair 2023 et al., on PCCLm vs OC in dogs, what was the most common urolith type in PCCLm cases?

A. Struvite
B. Calcium oxalate
C. Urate
D. Cystine
E. Mixed

Answer: Calcium oxalate

Explanation: Calcium oxalate uroliths were present in 74% of PCCLm cases vs 45.7% in OC (p < .001).
In Adair 2023 et al., on PCCLm vs OC in dogs, what was the most common reason for converting PCCLm to OC?

A. Foreign body in bladder
B. Inadequate visualization
C. Bladder wall hemorrhage
D. Uroliths too numerous to retrieve
E. Concurrent mass removal

Answer: Uroliths too numerous to retrieve

Explanation: 4 out of 5 conversions from PCCLm to OC were due to uroliths too numerous to retrieve endoscopically.
In Adair 2023 et al., on PCCLm vs OC in dogs, which factor was NOT significantly different between groups?

A. Rate of incomplete urolith removal
B. Length of skin incision
C. Postoperative urinary signs
D. Anesthesia duration
E. Hospital discharge timing

Answer: Rate of incomplete urolith removal

Explanation: There was no significant difference in incomplete urolith removal between PCCLm and OC (p = .112).

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