Basics of Female Repro Tract

Question 1

indications for ovariectomy

Answer 1

tumor - GTC
prevent estrus
ovarian abscess/hematoma
repro manipulation

Question 2

What are some considerations for pre-ovariectomy surgery?

Answer 2

temperament
size
uni/bilateral?
equipment

Question 3

what is involved in the colpotomy

Answer 3

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.

Question 4

Approaches to the ovariectomy

Answer 4

Flank approach - standing or lateral.

Ventral approach - midline or paramedian (people do the lateral but there have been lots of complications)

Question 5

What is involved in the modified grid?

Answer 5

incision through the skin
blunt dissect the muscle bellies along their axis
make the incision size a little bigger though

Question 6

the paramedian of ventral ovariectomy approach is better if…

Answer 6

massive ovary to deflate and then pull out. or just need for the size to get out.

Question 7

What is a common mistake with the lateral flank approach?

Answer 7

we will automatically make the incision lower down on the flank because of the position

Question 8

complications of ovariectomy

Answer 8

hemorrhage
evisceration
peritonitis
CV derangements
wound (flank) dehiscence
myopathy/neuropathy from GA

Question 9

Contra-indication to C-sections

Answer 9

if they aren’t ready to be born yet duh!

Question 10

Reasons for hysterotomy (C-section)

Answer 10

ELective 
-small pelvic canal
-vaginal mass
-reucurring cervical laceration
Emergency - dystocia
-full-term uterine torsion

Question 11

what to consider before doing hysterotomy (C-section)

Answer 11

fetal maturity
induce only after 1st stage of labor
have personel to deal with the foal

Question 12

What is important for the life of the mare when doing a hysterotomy (C-section)

Answer 12

that nothing from the uterus gets into the abdomen!!

Question 13

For the surgical procedure of hysterotomy (C-section), how do you go about closing?

Answer 13

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
finish up

Question 14

hysterotomy (C-section) complications

Answer 14

colic
hemorrhage
retained placenta
peritonitis
laminitis
uterine adhesions

Question 15

Post-op hysterotomy (C-section) care:

Answer 15

Fluids
AM
NSAIDs  - pain and anti-inflamm
Fluids
Oxytocin

Question 16

CLinical signs of uterine torsion

Answer 16

Low grade colic
(have on DDx if pregnant)
need rectal to know

Question 17

Approaches to uterine torsion

Answer 17

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

Question 18

Complications of uterine torsion

Answer 18

uterine necrosis
abortion
hemorrhage
GI trauma

Question 19

Prognosis to mares and foals

Answer 19

75% to mares

live foal 55-70%

Question 20

whats the worry with fixing the uterine prolapse?

Answer 20

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.

Question 21

Definition of urovagina

Answer 21

urine in the vaginal fornix

Question 22

what does urovagina cause?

Answer 22

vaginitis, cervicitis, decreased fertility

Question 23

predisposing factors to urovagina

Answer 23

tipped cervix and uterus so things drain in

Question 24

effects of urovagina on repro

Answer 24

sperm doesn’t like urine

Question 25

Dx of urovagina

Answer 25

speculum exam

Question 26

ddx to urovagina

Answer 26

exudate, always there?

Question 27

what is involved in a vestibuloplasty?

Answer 27

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

Question 28

what is urethroplasty?

Answer 28

lengthening the urethra

Question 29

post-operatively on the vestibuloplasty, …

Answer 29

AM, NSAIDS
monitor urination
don’t breed for 6-8 wks
check for a fistula in a few weeks

Question 30

indications for a caslick’s

Answer 30

penumovagina

fecal contamination

Question 31

factors that are considered when doing vulvoplasty

Answer 31

multiparous?
foaling injuries
general body condition
conformation of the vulva and

Question 32

When blocking for the vulvoplasty, what should you consider?

Answer 32

go at the pig/non-pigmented junction

start blocking from the bottom of the vulva up

Question 33

complications of the vulvoplasty

Answer 33

excress surgical trauma
fistula
vaginal reflux of urine
1-2nd perineal laceration if not removed before foaling

Question 34

When do we do perineal body reconstruction?

Answer 34

when vulvar and vestibular seals are not effective anymore

Question 35

perineal body transection (pourets’ proc) is indicated when…

Answer 35

pneumovag

urovag

Question 36

complications of the pourets’ procedure

Answer 36

infection/dehiscence
urovagina
fistula formation

Question 37

what does pourets’ procedure entail?

Answer 37

cutting sharp/bluntly the perineum in a triangular fashion and either suturing or leaving for second intention healing.

Question 38

recto-vaginal lacteration degrees entail…

Answer 38

1st - mucosa
2nd - muc/sub/musc
3rd - disrupt the perineal body, anal sphincter, floor of rectum and ceiling of vestibulee

Question 39

what can you do with a 2nd degree RV laceration?

Answer 39

nothing

NSAIDs, 4-6 wks, it will heal alot

Question 40

treatment of the 3rd degree RV laceration

Answer 40

wait 4-6 weeks
high fluids to slop the feces
change diet - don’t give oil though

Question 41

Actual repair of the 3rd degree RV laceration

Answer 41

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

Question 42

Complications of 3rd degree RV lacerations

Answer 42

repeat trauma
complete dehiscence
fistula formation
obstipation
urine pooling

Question 43

Prognosis for 3rd degree RV laceration

Answer 43

75% will breed again

Question 44

Cause of rectovestibular fistula

Answer 44

foaling injury

failure of 3rd degree RV to repair

Question 45

Methods for repair of Rvestibular fistula

Answer 45

conversion to a 3rd degree and treat that way (don’t though)
perineal body transection
vestibular approach