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Small Animal Surgery > Urethra > Flashcards

Urethra Flashcards

1
Q

What is hypospadias?

A
  • development of the terminal urethral orifice in an abnormal location
  • usually in a more proximal location
  • incomplete formation of penile urethra
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2
Q

How is hypospadias managed?

A
  • if not causing urine scald, no treatment needed

- if problems, reconstruct urethral orifice and remove any tissue

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3
Q

What are the predisposing factors/causes of urethral prolapse?

A
  • young, male brachycephalics

- primary conditions of straining: sexual excitement, UTIs, respiratory disorders

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4
Q

What are the clinical signs associated with urethral prolapse?

A
  • bleeding from prepuce
  • mucosa protruding from urethral orifice
  • licking
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5
Q

What are the treatment options for urethral prolapse?

A
  • reduce the prolapse with urethral purse string
  • reduce and place urethropexy suture
  • resection and anastomosis for necrotic or ulcerated tissue
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6
Q

Where are urethral obstructions most common in dogs?

A

ischial arch or just caudal to os penis

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7
Q

Where are urethral obstructions most common in cats?

A

in terminal area of the urethral (distal 1/3)

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8
Q

How are urethral obstructions diagnosed?

A
  • plain radiographs
  • ultrasound
  • contrast urethrography
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9
Q

What are the goals of urethral obstruction treatment?

A
  • maintain renal function and correct azotemia
  • correct electrolytes
  • temporarily relieve obstruction
  • treat UTI if present
  • prevent reoccurrence
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10
Q

How can a urethral obstruction be temporarily relieved?

A
  • catheter is the best
  • hydropropulsion
  • cystocentesis
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11
Q

When is a urethrotomy indicated?

A

when there is a calculi that cannot be hydropropulsed

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12
Q

Why perform a prescrotal urethrotomy in dogs?

A
  • common area of obstruction
  • less bleeding
  • heals better, less complications
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13
Q

What methods can be used for closure of a prescrotal urethrotomy in a dog?

A
  • primary closure using a fine suture (less hemorrhage)

- healing by second intention (less risk of stricture)

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14
Q

Why should a perineal urethrotomy be avoided if possible?

A
  • much deeper tissue
  • more cavernosus tissue (more bleeding)
  • higher incidence of infection
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15
Q

What is a urethrostomy?

A

creation of a permanent opening of the urethra at a new site

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16
Q

What are the indications for a urethrostomy?

A
  • permanent damage
  • recurrent urethral obstruction
  • obstruction that cannot be retropulsed or removed by urethrotomy
17
Q

What is the preferred area in the canine to perform a urethrostomy and why?

A
  • scrotal
  • less bleeding and complications
  • less urine scald
18
Q

How should you drape the patient during a scrotal urethrostomy?
How long should the incision be?

A
  • drape entire abdomen such that the prepuce, scrotum, and abdomen are exposed
  • incision should extend to the distal aspect of ischial arch
19
Q

What are the possible complications of scrotal urethrostomy?

A
  • hemorrhage
  • dehiscence
  • urine scald
  • stricture
  • UTI
20
Q

What is a disadvantage of prescrotal urethrostomy?

A

higher incidence of urine scald

21
Q

When is a perineal urethrostomy indicated in cats?

A
  • salvage procedure to treat LUTDS and calculi in male cats
  • frequent obstructions
  • strictures
  • trauma
22
Q

What are the goals of perineal urethrostomy in cats?

A
  • adequate mobilization of urethral mucosa
  • preserve internal pudendal nerve
  • widen urethral orifice
23
Q

How far should you dissect the urethra in a perineal urethrosotomy of a cat?

A

to the pelvic urethra and bulbourethral gland

24
Q

What are the complications of a perineal urethrostomy in a cat?

A
  • hemorrhage
  • UTI
  • stricture
  • subcutaneous urine
  • perineal hernia
  • urinary incontinence
  • urethrorectal fistula
25
Q

When is an antepubic urethrostomy indicated?

A
  • when there is not sufficient urethra
  • recurrent pelvic urethral obstruction
  • failed perineal urethrostomy
26
Q

What are the clinical signs associated with urethral trauma?

A
  • clinical signs associated with urine accumulation
  • electrolyte acidosis, hyperK, azotemia
  • hematuria, stranguria
  • SC or abdominal fluid accumulation
27
Q

How is urethral trauma diagnosed?

A

contrast media

28
Q

How is urethral trauma treated?

A
  • if minor, catheterize

- if severe, resection and anastomsis

29
Q

What are the causes of urethral strictures?

A
  • iatrogenic (catheterization)
  • urethral surgery
  • trauma by uroliths
  • healing after trauma
30
Q

When are clinical signs seen associated with urethral strictures?

A

when there is at least 60% narrowing of the urethra

31
Q

How are urethral strictures diagnosed?

A
  • urethrogram
  • cystoscopy
  • contrast media
32
Q

How are urethral strictures treated?

A
  • urethral dilators in females
  • balloon dilators in males
  • proximal urethrostomy
  • urethral stents

Small Animal Surgery (26 decks)

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