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LAS - RUSS > Equine Female Urogenital Sx 1 > Flashcards

Equine Female Urogenital Sx 1 Flashcards

1
Q

Episioplasty: Three surgical options from this approach?

A
  1. Caslick’s procedure
  2. Perineal body reconstruction
  3. Perineal body transection
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2
Q

Caslick’s Operation
1. aka ____

  1. Goal?
A
  1. Vulvoplasty

2. Tx pneumovagina by preventing aspiration of air into vagina

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3
Q

Caslick’s Procedure allows us to prevent:

1.
2.
3.
4.
5.
A
  1. Vaginitis
  2. Cervicitis
  3. Metritis
  4. Infertility
  5. Noise production
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4
Q

Preparation for Caslick’s Procedure:

  1. What position should horse be in?
  2. Drugs?
A
  1. Standing in stocks

2. Sedation / Local anesthetic / epidural anesthesia

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5
Q

Preparation for Caslick’s Procedure:

Cleaning / Site preparation?

A

Manually remove feces, bandage tail, scrub + Disinfect

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6
Q

Describe the Step-by-Step of Caslick’s procedure:

1.

2.

A
  1. remove ~ 3 mm of tissue of vulva

2. Vertical mattress suture, starting dorsally

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7
Q

Aftercare for Caslick’s Procedure?

A

Reopen before foaling via episiotomy!

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8
Q

Indications for Perineal body reconstruction:

1.
2.
3.

A
  1. Ineffective vulvar/vestibular seal
  2. Failed caslick’s procedure
  3. Rectovestibular injuries
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9
Q

Describe the steps of a perineal body reconstruction:

4.

A
  1. Incision at mucocutaneous junction of labium

2, Submucosal dissection of triangular section, removing a thin sliver of mucosa

  1. Retraction and suturing, starting cranially. Creating apposition of submucosal tissue
  2. Skin closure via deep horizontal mattress suture
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10
Q

Perineal body reconstruction: Aftercare:

1.
2.

A
  1. 4-6 weeks sexual rest

2. Episiotomy at foaling

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11
Q

Indications for Perineal Body Transection:

1.

2.

A
  1. Forward sloping of vulva

2. No decrease in vulvar and vaginal opening

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12
Q

What is a common cause of forward sloping of vulva that would require Perineal Body transection?

A

weight of uterus and fetus pulling cranially for years via multiple pregnancies/deliveries

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13
Q

Perineal Body transection:

Goal?

A

Break down tissue so we don’t have the step/sloping affect.

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14
Q

Two options for closure of Perineal body transection:

1.
2.

A
  1. Suture

2. Second intention healing

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15
Q

Urovagina: Two clinical presenations?

1.
2.

A
  1. Vesicovaginal reflux

2. Urine pooling

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16
Q

Urovagina: CxS:

1.
2.
3.
4.

A
  1. Vaginitis
  2. cervicitis
  3. endometritis
  4. Decreased conception rates
17
Q

Three potential causes of Urovagina?

1.
2.
3.

A
  1. Pneumovagina
  2. Ectopic ureter
  3. Excessive closure of Caslick’s
18
Q

Surgery options to Tx Urovagina?

1.
2.

A
  1. Caudal relocation of transverse fold aka Vaginoplasty

2. Caudal urethral extension (urethroplasty)

19
Q

Caudal Relocation of Transverse Fold aka Vaginoplasty:

Surgical Steps:

1.

2.

3.

A
  1. Incision in transverse fold
  2. Incision in vestibule wall
  3. Suture em together to create a more narrow vaginal opening
20
Q

Caudal Urethral Extension aka Urethroplasty:

Surgical Techniques:

1.
2.
3.
4.

A
  1. Brown
  2. McKinnon
  3. Shires
  4. Monin
21
Q

First step of Caudal Urethral extension aka urethroplasty?

A

Inserting catheter by guiding into along the floor into the urethral orifice

22
Q

Caudal Urethral extension aka urethroplasty

What do you do after you insert the catheter into the urethral orifice?

A

Suture the ventral shelf and create apposition, than repeat with the dorsal shelf

This creates an elongated urethra

23
Q

Describe the Shires technique for Caudal Urethral extension aka urethroplasty

A

After placing catheter, place a horizontal mattress suture through the mucosa on the left and another on the right side. Go from cranial to caudal for both patterns.

Take a sliver off the dorsal part to make it an open wound, suture that new wound closed, and leave the catheter in there for 3 days

24
Q

Common Foaling Injuries:

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
A
  1. Perineal Lacerations
  2. Rectovestibular fistulae
  3. Vaginal contusions
  4. Vaginal rupture
  5. Cervical lacerations
  6. Uterine rupture
  7. Uterine hemorrhage
  8. Uterine prolapse
  9. Uterine bladder eversion/prolapse/rupture
  10. GIT injuries
25
Q

Perineal laceration classifications:

1.
2.
3.

A
  1. First degree = only mucosa vestibule, vulva
  2. Second Degree = Mucosa + submucosa
  3. Third Degree = Perineal body, anal sphincter, floor of rectum
26
Q

What kind of perineal laceration is most common in younger mares?

A

3rd degree due to it being their first time foaling

27
Q

3 Main causes of Perineal laceration:

1.
2.
3.

A
  1. Primiparous mares
  2. Fetal malposition
  3. Nose or foot catches vulvovaginal fold
28
Q

Repair of 3rd Degree Perineal Lacerations:

  1. Technique? What position should horse be in?
  2. ____ prophylaxis.
  3. Repair when?
  4. Aftercare?
A
  1. Local debridement in standing horse.
  2. Tetanus
  3. 4-6 weeks post-partum, after weaning
  4. Diet change to create softer feces
29
Q

4 Basic Surgical Principles for Repair of 3rd Degree Perineal Laceration:

1.
2.
3.
4.

A
  1. Minimum tension on suture line
  2. Broad contact of wound surfaces
  3. Strong suture material
  4. Reduce amount of feces
30
Q

Two methods for Rectovestibular Repair and when to use them?

1.
2.

A
  1. Aanes method = for second stage of repair

2. Goetze or Vaughan Method = single stage repair

31
Q

Rectovestibular Repair: First Stage Repair:

  1. Goal?
  2. Broads steps?
A
  1. Recreate rectum floor

2. Incise, suture with simple interrupted to appose submucosal tissue and invert vestibular mucosa

32
Q

Rectovestibular Fistula:

  1. Definition?
A

Laceration of dorsal vestibula into rectum WITHOUT disruption of perineal body or anal sphincter

33
Q

T/F: It is always recommended to repair a rectovestibular fistula surgically

A

F, small ones can close spontaneously

34
Q

Two APPROACHES to repair of Rectovestibular Fistula:

  1. 2.
A
  1. Via rectum

2. Via vestibula/perineal body

35
Q

Two TECHNIQUES of Rectovestibular fistula repair

1.
2.

A
  1. Direct closure of fistula

2. Via creation of third-degree laceration, and than repairing that

36
Q

Describe the rectal approach to repair of rectovestibular fistula

A

Incise into margin of fistula, and trim a little sliver off.
Place a continous suture pattern to disperse tension along the suture evenly.
It may tear, but every time you re-suture it, it should get smaller

37
Q

Describe the incision to create a third degree perineal laceration as treatment for Rectovestibular fistula

A

A midline longitudinal incision in the vaginal shelf

LAS - RUSS (32 decks)

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