SOFT TISSUE SX 12

Question 1

describe the steps to a uretero-nephrectomy

Answer 1

-ligate artery first, ligate vein. cut between both ligature
-same toothpaste squeezing mechanism as a castration to squeeze the fat from renal end of ureter down to bladder
-double ligatures again near ureter-bladder junction. remove

Question 2

what are 5 causes of urinary incontinence?

Answer 2

Question 3

is ectopic ureter more common in males or females?
-breed predisp?

Answer 3

female
retriever, poodle, husky

Question 4

Answer 4

Question 5

what is the tx of an intramural ectopic ureter?
extramural ectopic ureter?

Answer 5

extra: fully chop it off and attach it to bladder
intra: laser chops the inside bit of bladder

Question 6

what are steps to a neoureterostomy?

Answer 6

Question 7

what are steps to a ureteroneocystostomy

Answer 7

step C: “spatulated” into bladder
step D: single interrupted suture

Question 8

pathophysiology of USMI? urinary sphincter mech incomptence

Answer 8

-basically abdomen no longer compressing bladder neck

Question 9

first, USMI will be medically managed. what are options for this?

Answer 9

Question 10

if medical management does not work, USMI will be surgically managed. what are big 3 options for this?

Answer 10

-collagen injection
-colposuspension
-artificial urethral sphincter

Question 11

describe steps to a colposuspension

Answer 11

-squishes vagina and prepubic tendon together::: pushes the bladder cranially, lengthens urethra and increases pressure in urethra

Question 12

bulking agents in USMI:
-what is their goal?
-what is a downside?

Answer 12

Question 13

describe artificial urethral sphincter
-advantages
-disadvantages

Answer 13

-cuff placed around urethra. cuff has a SQ port that can be injected with saline to increase pressure
-advantage: ability to modify post operatively
-disadvantage: lots of foreign material
risk due to need to dissect around urethra