Case description: An 11-year-old Arabian gelding was evaluated for hematuria, stranguria, and pollakiuria that had been observed for 1 week.
Clinical findings: Transrectal palpation revealed a 5-cm firm round mass in the urinary bladder. Cystoscopy and transrectal ultrasonography confirmed the diagnosis of urinary bladder urolithiasis.
Treatment and outcome: A multiportal transparalumbar fossa laparoscopic approach was selected for cystotomy and urolith removal. Cystotomy and urolith removal was performed with sedation and local anesthesia with the horse standing. No perioperative complications were observed. Urination returned to normal 5 days after surgery. The horse returned to its previous level of activity at 3 weeks after surgery.
Clinical relevance: Findings suggested that minimally invasive transparalumbar fossa laparoscopic approach can be successfully used for cystotomy and urolith extraction in standing horses; this avoids the disadvantages of conventional laparocystotomy for removal of large uroliths in male equids and the potential complications of general anesthesia and recovery. The technique provided excellent viewing and access to the bladder, permitting extraction of the urolith and secure closure of the cystotomy with minimal tension and tissue trauma to the bladder.