Urogenital surgery (Yr4)

Question 1

what are the possible clinical signs of prostatic disease?

Answer 1

anorexia, lethargy, weight loss, pyrexia
urinary… dysuria, haematuria, urine retention
defaecatory… tenesmus, ribbon-like faeces, constipation
stiffness and straddling gait

Question 2

what are the possible disease effecting the prostate?

Answer 2

benign prostatic hyperplasia
prostatitis
abscessation
cysts
neoplasia

Question 3

what is the signalment of benign prostatic hyperplasia?

Answer 3

older middle aged entire dogs

Question 4

what is found when rectalling dogs with benign prostatic hyperplasia?

Answer 4

symmetrically enlarged pain-free prostate with a homogenous consistency

Question 5

how is benign prostatic hyperplasia treated?

Answer 5

castration (caused by androgens)
anti-androgen drugs but not as effective as castration

Question 6

what causes prostatitis/abscessation?

Answer 6

ascending infection from urethra (often proceeding benign prostatic hyperplasia)

Question 7

what is the typical organism that causes prostatitis/abscessation?

Answer 7

E. coli

Question 8

what is found on rectal palpation of patients with prostatitis/abscessation?

Answer 8

asymmetrically enlarged painful prostate (pain on abdominal palpation also)

Question 9

how is prostatitis/abscessation treated?

Answer 9

antimicrobials for 4-6 weeks along with castration
can also drain but they often reoccur and can burst to cause a peritonitis

Question 10

what is the difference between a prostatic and paraprostatic cyst?

Answer 10

paraprostatic - outside of prostate capsule and don’t communicate but are attached to the prostate
prostatic - within the capsule of the prostate

Question 11

what is found on rectal of prostatic cysts?

Answer 11

prostate not palpable

Question 12

how are prostatic cysts treated?

Answer 12

US guided drainage or surgical resection
castration

Question 13

what is the most common prostatic neoplasia seen in dogs?

Answer 13

adenocarcinomas

Question 14

what is found on rectal palpation of prostatic neoplasias?

Answer 14

pain and enlarged prostate

Question 15

what palliative care is available for prostatic neoplasias?

Answer 15

cystotomy or urethral stenting
analgesia
radiation therapy

Question 16

what are the three types of testicular neoplasia?

Answer 16

interstitial cell (leydig) tumour
Sertoli cell tumour
seminoma

Question 17

what is a common clinical sign of sertoli cell tumours?

Answer 17

feminisation syndrome (penile atrophy, attraction to males, gynecomastia, galactorrhea, oestrogen can cause myelotoxicity)

Question 18

what is phimosis?

Answer 18

inability to protrude penis from prepuce

Question 19

what causes phimosis?

Answer 19

narrowing of preputial opening from infection or congenital malformation

Question 20

what is paraphimosis?

Answer 20

inability to retract penis into the prepuce

Question 21

what are the surgical treatment options for paraphimosis?

Answer 21

enlargement of preputial opening
phallopexy
penile amputation

Question 22

what are the contraindication of neutering before the first season?

Answer 22

juvenile vaginitis
juvenile urethral sphincter mechanism incompetence

Question 23

what is the pathogenesis of how pyometra forms?

Answer 23

during the luteal phase progesterone stimulates growth/activity of the endometrial glands along with suppressing the immune system which can lead to mucous/blood collecting which can turn septic

Question 24

what is the main pathogen that causes pyometra?

Answer 24

E. coli

Question 25

what are some clinical signs of pyometra?

Answer 25

PUPD, lethargy, inappetence, vomiting, pyrexia, dehydration, pain , vaginal discharge (can lead to SIRS)

Question 26

what would be a good antibiotic choice for a pyometra?

Answer 26

cefuroxime or amoxicillin/clavulanic acid

Question 27

what is the preferred treatment for a pyometra?

Answer 27

ovariohysterectomy

Question 28

what is needed for a uterine stump pyometra to form?

Answer 28

a progesterone source (ovarian remnant)

Question 29

what is the major clinical signs of ovarian remnant syndrome?

Answer 29

recurrent oestrus signs (attraction to males, enlarged vulva...)

Question 30

how can ovarian remnant syndrome be diagnosed?

Answer 30

history and vaginal cytology hormone assays (progesterone, anti-mullerian hormone)

Question 31

what causes a uterine stump granuloma?

Answer 31

poor aseptic technique using non-absorbable suture for ligatures excessive uterine body remaining

Question 32

when does vaginal hyperplasia occur?

Answer 32

during proestrus/oestrus under the influence of oestrogen, leading to oedematous enlargement of the vagina

Question 33

what can vaginal hyperplasia lead to?

Answer 33

prolapse

Question 34

what is the recommended treatment for vaginal hyperplasia (prolapse)?

Answer 34

lubricate and prevent self-trauma resect if tissue is non-viable spaying is recommended

Question 35

what us episioplasty?

Answer 35

reconstructive surgery to remove excess skin folds around the vulva which might be causing problems such as peri-vulvar dermatitis

Question 36

where can ovarian neoplasias arise from?

Answer 36

germ cells (teratoma, teratocarcinoma) epithelial (adenoma, adenocarcinoma) sex cord stromal (granulosa cell tumour)

Question 37

what are the most common uterine neoplasias?

Answer 37

dogs... leiomyomas cats... adenocarcinomas (rare)

Question 38

what is the prognosis for inflammatory carcinomas?

Answer 38

poor (highly metastatic and rapidly progressive)

Question 39

what is the innervation for the filling/storage phase of the bladder?

Answer 39

mainly sympathetic (via hypogastric nerve)... beta-adrenoreceptors in detrusor muscle (relaxation) alpha-adrenoreceptors in urethral smooth muscle and trigone (contract)

Question 40

what is the innervation for the emptying phase of the bladder?

Answer 40

parasympathetic (via pelvic nerve)... detruser reflex is when the stretch receptors of the bladder wall are stimulated causing contraction

Question 41

what allows you to have voluntary control over the detrusor reflex?

Answer 41

cerbral cortex

Question 42

what are the typical findings of a filling phase incontinence?

Answer 42

patients urinate/empty bladder normally dribble urine between urinations reduced bladder capacity

Question 43

what are some differentials for filling phase bladder incontinence?

Answer 43

ectopic ureter reduced pressure at the bladder neck involuntary contractions (infection, drugs, neoplasia, calculi)

Question 44

what are the typical abnormalities of incontinence associated with the emptying phase?

Answer 44

distended bladder no normal urination often dribble urine

Question 45

what are some differentials for incontinence relating to the emptying phase?

Answer 45

partial/complete urethral obstruction chronic bladder distention (trauma...) dyssynergia (poor muscle coordination)

Question 46

what is the most common form of incontinence in the bitch?

Answer 46

urethral sphincter mechanism incompetence

Question 47

what are the clinical signs of urethral sphincter mechanism incompetence?

Answer 47

intermittent involuntary passage of urine usually whilst relaxed don't dribble urine and can urinate normally

Question 48

what are some causes of urethral sphincter mechanism incompetence?

Answer 48

low urethral tone hormonal (spaying prior to first season) obesity intrapelvic bladder

Question 49

what breeds typically get urethral sphincter mechanism incompetence?

Answer 49

doberman, boxers, Irish setters

Question 50

how can urethral sphincter mechanism incompetence be treated medically?

Answer 50

increase muscle tone (phenylpropanolamine) estriol reduce contributing factors (weight loss, UTI...)

Question 51

what is the difference between an intramural and extramural ectopic ureter?

Answer 51

intramural - tunnels through the bladder to connect to urethra/rectum extramural - completely bypasses the bladder

Question 52

what is a possible consequence of prolonged ureteric obstruction in cats?

Answer 52

hydronephrosis

Question 53

what stage of the oestrus cycle should you neuter a bitch?

Answer 53

anoestrus

Question 54

when should early neutering (before the first season) be avoided?

Answer 54

if congenital USMI or juvenile vaginitis is present (these need hormones to resolve)

Question 55

what is the difference between open and closed castration?

Answer 55

open incises through the vaginal tunic