In a female cat with large bladder stones, what surgical procedure is indicated for stone removal?

• A. Cystocentesis
• B. Lithotripsy
• C. Urethral dilation
• D. Cystotomy

Answer: (D)

Opening the bladder surgically (cystotomy) is indicated when there are large stones inside the bladder. This approach provides direct access to the bladder, allowing the stones to be removed intact or as a minimal number of fragments in a single procedure, which minimizes the risk of leaving residual stones and reduces trauma to the urinary tract.

Cystocentesis would only obtain a urine sample and does not remove stones. Lithotripsy aims to break stones into smaller pieces, but large stones can be difficult to fragment effectively and may require multiple sessions or specialized equipment; it’s not as reliable for complete removal in one operation. Urethral dilation addresses obstruction at the urethra, not intravesical stones, so it wouldn’t resolve large bladder stones.