Flashcards in Basics of Female Repro Tract Deck (45):
indications for ovariectomy
tumor - GTC
What are some considerations for pre-ovariectomy surgery?
what is involved in the colpotomy
vag incision forward in cervix over to the ovaries.
Best to give topical anesthetic
then the chain ecraseur to cut out.
Don't suture vaginal wall closed
give NSAIDs, AM, and keep standing for 4-5 days.
Approaches to the ovariectomy
Flank approach - standing or lateral.
Ventral approach - midline or paramedian (people do the lateral but there have been lots of complications)
What is involved in the modified grid?
incision through the skin
blunt dissect the muscle bellies along their axis
make the incision size a little bigger though
the paramedian of ventral ovariectomy approach is better if...
massive ovary to deflate and then pull out. or just need for the size to get out.
What is a common mistake with the lateral flank approach?
we will automatically make the incision lower down on the flank because of the position
complications of ovariectomy
wound (flank) dehiscence
myopathy/neuropathy from GA
Contra-indication to C-sections
if they aren't ready to be born yet duh!
Reasons for hysterotomy (C-section)
-small pelvic canal
-reucurring cervical laceration
Emergency - dystocia
-full-term uterine torsion
what to consider before doing hysterotomy (C-section)
induce only after 1st stage of labor
have personel to deal with the foal
What is important for the life of the mare when doing a hysterotomy (C-section)
that nothing from the uterus gets into the abdomen!!
For the surgical procedure of hysterotomy (C-section), how do you go about closing?
it will bleed like crazy
stop the bleeding with the roundy-roundy-on each side of the incised uterus
then once stopped, peel some placenta away to let it pass on it's own
close with a double inverting
hysterotomy (C-section) complications
Post-op hysterotomy (C-section) care:
NSAIDs - pain and anti-inflamm
CLinical signs of uterine torsion
Low grade colic
(have on DDx if pregnant)
need rectal to know
Approaches to uterine torsion
Rolling +/- plank - need confidence and muscle. not done
standing flank - blind, but gravity
ventral midline - fill w/ water to help. also can explore a lot
Complications of uterine torsion
Prognosis to mares and foals
75% to mares
live foal 55-70%
whats the worry with fixing the uterine prolapse?
may have torn and is occluded but now will hemorrhage when fixed
Also, the bladder will be blocked so when corrected, will be peed on.
Definition of urovagina
urine in the vaginal fornix
what does urovagina cause?
vaginitis, cervicitis, decreased fertility
predisposing factors to urovagina
tipped cervix and uterus so things drain in
effects of urovagina on repro
sperm doesn't like urine
Dx of urovagina
ddx to urovagina
exudate, always there?
what is involved in a vestibuloplasty?
cut fresh edges on the transverse process of the vagina and suture it to more forward tissue. put a roof over the urine. But suturing is in the dark
what is urethroplasty?
lengthening the urethra
post-operatively on the vestibuloplasty, ...
don't breed for 6-8 wks
check for a fistula in a few weeks
indications for a caslick's
factors that are considered when doing vulvoplasty
general body condition
conformation of the vulva and
When blocking for the vulvoplasty, what should you consider?
go at the pig/non-pigmented junction
start blocking from the bottom of the vulva up
complications of the vulvoplasty
excress surgical trauma
vaginal reflux of urine
1-2nd perineal laceration if not removed before foaling
When do we do perineal body reconstruction?
when vulvar and vestibular seals are not effective anymore
perineal body transection (pourets' proc) is indicated when...
complications of the pourets' procedure
what does pourets' procedure entail?
cutting sharp/bluntly the perineum in a triangular fashion and either suturing or leaving for second intention healing.
recto-vaginal lacteration degrees entail...
1st - mucosa
2nd - muc/sub/musc
3rd - disrupt the perineal body, anal sphincter, floor of rectum and ceiling of vestibulee
what can you do with a 2nd degree RV laceration?
NSAIDs, 4-6 wks, it will heal alot
treatment of the 3rd degree RV laceration
wait 4-6 weeks
high fluids to slop the feces
change diet - don't give oil though
Actual repair of the 3rd degree RV laceration
have 3 suture lines. One for the vagina, one for the rectum and one in the middle. . Need to work with all three at a time. start deep.
Can do 2-stage or single stage but 2 needs 3-4 weeks in between repairs. Do the vagina first in this case
Complications of 3rd degree RV lacerations
Prognosis for 3rd degree RV laceration
75% will breed again
Cause of rectovestibular fistula
failure of 3rd degree RV to repair