Boone et al: Outcomes and comparison of modified percutaneous cystolithotomy and traditional open cystotomy in 52 cats
Veterinary Surgery 4, 2026

🔍 Key Findings

Modified percutaneous cystolithotomy (PCCLm) resulted in significantly shorter skin incisions and hospitalization duration compared with open cystotomy (OC) (p=.002 and p=.031, respectively).
PCCLm cats had fewer immediate postoperative lower urinary tract signs and were more often asymptomatic postoperatively than OC cats (p=.046 and p=.006).
Rates of incomplete urolith removal were similar between PCCLm and OC, indicating no clear advantage in stone clearance for either technique.
No PCCLm procedures required conversion to open surgery, demonstrating technical feasibility in cats.
Clinical urolith recurrence rates were low and similar between PCCLm (10.5%) and OC (8.6%).
In PCCLm, incomplete stone removal was associated with longer anesthesia time, longer hospitalization, larger incision length, and postoperative LUTS.
In OC, incomplete stone removal was associated with longer surgery time and obstructed/distended bladders at presentation.
PCCLm is an acceptable minimally invasive alternative to OC, although it did not reduce surgical site infection rates or incomplete stone removal.

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Boone et al: Outcomes and comparison of modified percutaneous cystolithotomy and traditional open cystotomy in 52 cats
Veterinary Surgery 4, 2026

🔍 Key Findings

Modified percutaneous cystolithotomy (PCCLm) resulted in significantly shorter skin incisions and hospitalization duration compared with open cystotomy (OC) (p=.002 and p=.031, respectively).
PCCLm cats had fewer immediate postoperative lower urinary tract signs and were more often asymptomatic postoperatively than OC cats (p=.046 and p=.006).
Rates of incomplete urolith removal were similar between PCCLm and OC, indicating no clear advantage in stone clearance for either technique.
No PCCLm procedures required conversion to open surgery, demonstrating technical feasibility in cats.
Clinical urolith recurrence rates were low and similar between PCCLm (10.5%) and OC (8.6%).
In PCCLm, incomplete stone removal was associated with longer anesthesia time, longer hospitalization, larger incision length, and postoperative LUTS.
In OC, incomplete stone removal was associated with longer surgery time and obstructed/distended bladders at presentation.
PCCLm is an acceptable minimally invasive alternative to OC, although it did not reduce surgical site infection rates or incomplete stone removal.

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Multiple Choice Questions on this study

In Boone 2026 et al., on feline urolith surgery, what was the authors' overall conclusion regarding modified percutaneous cystolithotomy?

A. It should replace open cystotomy in all cats

B. It is contraindicated in obstructed cats

C. It significantly reduces incomplete stone removal

D. It is an acceptable alternative to open cystotomy

E. It has higher recurrence rates than open cystotomy

Answer: It is an acceptable alternative to open cystotomy

Explanation: The authors concluded PCCLm is a viable minimally invasive alternative, although it did not reduce SSI or incomplete stone removal rates.

In Boone 2026 et al., on feline urolith surgery, what postoperative advantage was observed in cats undergoing modified percutaneous cystolithotomy?

A. Higher complete stone removal rate

B. Fewer lower urinary tract signs

C. Lower recurrence rate

D. Shorter anesthesia duration

E. Lower surgical complication rate

Answer: Fewer lower urinary tract signs

Explanation: PCCLm cats had significantly fewer immediate postoperative LUTS and were more frequently asymptomatic after surgery.

In Boone 2026 et al., on feline urolith surgery, what was the clinical recurrence rate of urolithiasis in cats undergoing modified percutaneous cystolithotomy?

A. 2.1%

B. 5.3%

C. 10.5%

D. 21.0%

E. 33.3%

Answer: 10.5%

Explanation: Two of nineteen PCCLm cats developed clinical recurrence requiring diagnostics or intervention, yielding a recurrence rate of 10.5%.

In Boone 2026 et al., on feline urolith surgery, which factor was associated with incomplete urolith removal in the open cystotomy group?

A. Positive urine culture

B. Previous cystotomy

C. Longer surgery time

D. Older age

E. Smaller incision length

Answer: Longer surgery time

Explanation: In OC cases, increased surgical time was significantly associated with incomplete urolith removal (p=.039).

In Boone 2026 et al., on feline urolith surgery, which variable was significantly lower in cats undergoing modified percutaneous cystolithotomy compared with open cystotomy?

A. Anesthetic time

B. Surgical time

C. Skin incision length

D. Urolith recurrence rate

E. Incomplete urolith removal rate

Answer: Skin incision length

Explanation: Incision length was significantly shorter in PCCLm cats (p=.002), one of the main differences between procedures.

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