Ch 110 - Vagina, Vestibule and Vulva Flashcards
What embryological structure forms the cranial vagina?
Fusion of the paired paramesonephric (Mullerian) ducts
What kind of epithelium does the vagina have?
Nonglandular, stratified squamous epithelium
What it the blood supply to the vagine, urethra, vestibule and vulva?
- Vagina, urethra and vestibule - Vaginal artery (arises from internal pudendal)
- Vulva - External pudendal artery
What are the most common commensal organisms of the canine vagina?
- E.Coli
- B-haemolytic Strep
- Staph pseudintermedius
- Pasteurella multocida
What sized endoscope can be used for vaginoscopy?
- Small dogs and cats 3-5kg - 2.7mm rigid cystoscope with 10Fr sheath
- Dogs over 10kg - 4mm scope with 19Fr sheath
List the approaches to the vagina
- Episiotomy
- Ventral approach (pubic symphysiotomy/ectomy)
- Combined abdominal and perineal approach
List the forms of congenital vestibulovaginal stenosis
- Focal hypoplasia
- Imperforate hymen
- Vertical septum (vagina septa)
- Double vagina
What is the cause of vestibulovaginal stenosis?
Retained epithelial tissue at the point of fusion of the paired paramesonephric ducts in the sagittal plane (vertical spetum) or at the transverse junction of the paramesonephric ducts with the urogenital sinus (imporforate hymen)
What clinical signs may be seen with vestibulovaginal stenosis?
- Difficultly or pain associated with breeding
- Recurrent vaginitis
- Hydrocolpos (fluid accumulation within the vagina)
- Recurrent UTIs
List the surgical options for vestibulovaginal stenosis
Vertical septa:
- Endoscopic laser ablation (Nd:YAG, Ho:YAG, diode)
- Endoscopic scissors
- Episiotomy with resection of septum at dorsal and ventral attachment
Annular:
- Circumferential partial thickness resection of mucosa and submucosa
- T-shaped vaginoplasty (1/5 had good outcome…)
- Complete resection and anastomosis (decreased fertility)
- Complete vaginectomy (Caudal laparotomy with pelvis osteotomy or episiotomy)
Define rectovaginal fistulas and anovulvar clefts
- Rectovaginal fistula: A connection between the rectum and vagina or vestibule, typically assoc with atresia ani
- Anovulvar cleft: Failure of fusion between the dorsal urogenital folds leaving a midline defect in the perineal skin that normally seperates the anus and dorsal vulva commisure
What is the surgical treatment of an anovulvar cleft?
Inverted V perineoplasty
What is the prognosis for treatment of a recessed vulva with episioplasty?
Resolution of UTI in 84-100%
What is vaginal oedema?
What is the recommended Tx?
- Certain young, femal entire dogs develop a mass of oedematous tissue arising from the ventral floor of the vagina, just cranial to the urethral tubercle, under the influence of oestrogen in late proestrus and oestrus
- Will resolve with termination of oestrus however recurrence is high, OVH is recommended
- Resection of oesematous tissue can be performed if it has become traumatised or in breeding animals
List potential causes of clitoral hypertrophy
- Spontanous idiopathic
- Exogenous androgens
- Intersex conditions