Bladder/Urethra Sx

Question 1

Obj: know the surgical principles of the bladder

Question 2

Obj: Know how to perform a cystotomy?

Question 3

Obj: Know how to diagnose and treat urethral obstruction

Question 4

Obj: Know the indications and techniques for urethrostomy

Question 5

What are the surgical principles of the bladder?

Answer 5

• Gentle tissue handling
• maintain blood supply
• Isolate and pack off abdomen
• Submucosa is holding layer
• Absorbable suture
• Appositional patterns
• Healing reaches near 100% by 14-21 days

Question 6

What are the clinical signs of urolithiasis?

Answer 6

• Hematuria
• Stranguria
• Pollakiuria
• Recurrent UTI

Question 7

How is urolithiasis diagnosed?

Answer 7

• UA
• Radiographs
• Ultrasound

Question 8

What are the possible treatments for urolithiasis?

Answer 8

• Cystotomy
• Medical dissolution
• endoscopic retrieval

Question 9

What is the surgical approach to a cystotomy?

Answer 9

• Caudal or Ventral midline approach
  
  • avoid dorsal due to entrance of ureters
  • Ventral allows catheterization of ureters if necessary and easier access
  • No difference in healing

Question 10

What animals should receive a scrotal castration?

Answer 10

• Standard for feline castration
• Ideal for pre-pubertal dogs
  
  • testicle advancement can be harder to achieve
  • But may cause more irritation / complications for older dogs

Question 11

What are the benefits for castration?

Answer 11

• Decrease the risk/rate of overpopulation
• Decrease sexually dimorphic behaviors
• Reduces the risk of androgen-related diseases
  
  • benign prostatic hypertrophy, prostatitis, prostatic cysts/abscesses, perineal hernias, perineal adenomas
• Eliminates risk of testicular neoplasia
  
  • cryptorchidism are 8-16x more likely to undergo neoplastic transformation

Question 12

What are the drawbacks of castration?

Answer 12

• Increased risk of prostatic carcinoma, transitional cell carcinoma of the bladder, lymphoma, mast cell tumor, hemangiosarcoma, and osteosarcoma
  
  • Especially if castrated prior to 1 year of age
  • Risk is typically 2-5x that of an intact dog
  • results are disputed or these studies are breed specific
• Potential increased risk of certain orthopedic diseases
  
  • cranial cruciate ligament rupture, hip dysplasia, elbow dysplasia
• Potential development of undesirable behaviors
  
  • tenuous claim
• Decreased activity level and subsequent obesity
  
  • easily preventable

Question 13

describe the anatomy of the scrotal skin

Answer 13

• Divided into 2 cavities