Sx of urethra Flashcards
what is hypospadias & how do you manage it
incomplete formation of penile urethra
urethral orifice can occur anywhere along penis
what is urethral prolapse, what are CS, what are predisposing causes, criteria for tx, tx options, adjunct tx
protrusion of urethral mucosa through orifice
CS: bleeding from prepuce, licking, red-purple mass
young male brachycephalic dogs, sexual excitement, dyspnea, infection
viable tissue, reducible
tx opt: reduce & purse string, urethropexy, or, resection & anastomosis
adjunct tx: castration/airways
what are CS of urethral trauma, how dx it, how manage it
what causes urethral obstruction in dogs & cats & where is obstruction most common
Calculi, mucus plugs
cats: distal 1/3 of urethra
dogs: ischial arch/ cd penis
how do you diagnose urethral obstruction, what are goals of tx
plain radiographs: calculi & bladder distension
u/s
contrast urethrography
goals: restore/preserve renal function
relieve obstruction
treat UTI
prevent reoccurence
how do you temporarily relieve urethral obstruction in a dog or cat due to calculi
catheter
hydropropulsion
cystocentesis
where, when & why would you perform a urethrotomy in a dog & what are the methods available for closure (advantages & disadvantages of each)
prescrotal (preferred), perineal,
if hydropropulsion unsuccessful
prescrotal: primary closure w/ 4/0 or 5/0 monofilament absorb or 2nd intention
perineal: primary closure
why is perineal urethrotomy & urethrostomy a less preferred procedure in the dog
Difficult procedure (urethra deeper) Increase risk of infection
More tension
More cavernous tissue
More urine scald
More UTI
Stenosis
what is a urethrostomy & what are the preferred location is in dog & cat & why
Forming a permanent opening of the urethra at a new site
Dogs:
Scrotal (preferred) - More superficial
Relatively wide urethra
Less hemorrhage
Less urine scald compared to perineal and prescrotal
Prescrotal
Antepubic
Perineal
Cats:
Perineal
A salvage procedure to treat FLUTDS and calculi in male cats
Antepubic
in a scrotal urethrostomy, what structures should be draped in you surgical field, how long should the urethral incision be,
what is the most appropriate suturing method
what are the complications with the procedure
penis & scrotum
2.5-4 cm long (5-8x urethral diameter), caudal extent where urethr turns dorsally into ischial arch
4/0-5/0 monofilament appose skin & mucosa, don’t engage cavernous tissue
Hemorrhage, Dehiscence, Urine scald, Stricture, UTI,
what is a disadvantage of a canine prescrotal urethrostomy
Higher incidence of urine scald
when is a perineal urethrostomy in a cat indicated & what are the goals of the procedure
frequent obstructions, strictures, trauma
Adequate mobilization of urethral mucosa
Preserve urethral branches of Internal pudendal nerve with minimal dorsal
dissection
Wide urethral orifice
what gland/area of the urethra do you dissect to when performing a perineal urethrostomy in a cat
how can you check the urethral orifice is wide enough
BBU gland
insert mosquito hemostat to hinge
what are the complications of a perineal urethrostomy in a cat & how can you minimize the complications
Hemorrhage - Resolves over time
Urinary tract infection
Stricture - Surgical technique
Revision procedure or antepubic procedure
Subcutaneous urine -
Urethral tear or improper suturing
Catheterize for 5-7 days
Perineal hernia
Urinary incontinence - Rare
Dorsal dissection causing disruption of pudendal nerves
Urethrorectal fistula -Poor surgical technique
when is a antepubic urethrostomy indicated & what are the complications
Recurrent pelvic urethral obstruction
Failed perineal urethrostomy that cannot be revised
Urine scald
UTI
Incontinence
