110.Vagina, Vestibule, Vulva Flashcards Preview

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Flashcards in 110.Vagina, Vestibule, Vulva Deck (12):
1

how is the vagina formed

fusion of the paired paramesonephric (Mullerian ducts) to create a single tube the unites the the caudal urogenital sinus to make the vestibulovaginal jxngenital tubercle = clitoris = penis in males

2

blood supply to the vagina

vaginal artery---from internal pudendal artery supplies vagina, urethra and vestibulevulva is supplied by branches of the external pudendal artery

3

diagnostics for vaginal/vestibular disease

--PE--rectal---aseptic digital vulvar vaginal exam+/- culture (Pastuerella, Ecoli, B hemolytic Strep--positive contrast vaginourethrogram--vaginoscopy +/- biopsy

4

two approaches to the vagina

1. dorsal episiotomy (through vestibular constrictor muscle and mucosa)2. ventral approach +/- pubic symphysis osteotomy +/- pubic and ischial osteotomy (caution obturator n)use urinary catheter !!

5

congenital/developmental anomalies of the vestibulovaginal junction

VESTIBULOVAGINAL STENOTIC LESIONS1. focal hypoplasia2. imperforate hymen3. double vagina4. vertical septumpresent with recurrent vaginitis, UTI, misbreeding, hydrocolpos (fluid retention in vagina)std endoscopic scissors and/or Nd:YAG laser can resect thin septum or imperforate hymenresection, vaginoplasty (poor outcome) or complete vaginectomy needed to fix focal hypoplasia (if annular lesion)

6

approaches for a vaginectomy

---caudal midline + pelvic osteotomy---episiotomy after OHE has been performedU cath in placeclose with Parker Kerr Oversew when done thru a caudal laparotomyclose with mucosal apposition if thru episiotomy

7

rectovaginal fistulas are associated with what other congenital abnormalities

atresia ani!

8

surgical option for recessed vulva

episioplasty/vulvuloplasty~50% dogs have UTI, 50% have urinary incontinence, 50% referred for vaginitis/dermatitissurgery resolved UTI in 80-100% of dogs

9

ddx of soft tissue protruding from vagina

1. vaginal edema (mucosal swelling from E in proestrus/estrus)2. vaginal prolapse (rare)3. vaginal neoplasia4. clitoral hypertrophy

10

tx for vaginal edema

--resolve on own with termination of estrus (keep moist, prevent licking--OHE--amputation of mucosa +/- episiotomy for exposure***recurrence is high in intact bitches***

11

tx for vaginal prolapse

---manual reduction followed by OHE---CAUTION additional organs can be prolapse with vagina may need cystopexy or colopexy

12

neoplasia of the vagina/vestibule

mostly benign 80% (pedunculated)leiomyomas (most common), fibromas, cysts, polypsbenign masses removed with episiotomy and amputationmost common malignancy leimyosarcoma followed by others: fibrosarcoma, TVT, TCC, HSAmalignant masses removed with vulvovaginectomy with perineal urethrostomy (preserve vaginal artery and branches to urethra)

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