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RUSVM Small Animal Surgery 2017 > Urogenital and Reproductive Surgery > Flashcards

Urogenital and Reproductive Surgery Flashcards

1
Q

How do you treat non functional ovarian cyst?

A

OHE

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2
Q

How do you diagnose Functional Ovarian Cyst?

A

Vaginal Cytology

Abdominal Ultrasound

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3
Q

What is the treatment for a breeding animal with functional ovarian cyst?

A 
May resolve spontaneously 
GnRH
HCG
Cyst removal 
Unilateral Ovariectomy
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4
Q

How do you treat a functional ovarian cyst of a non breeding animal?

A

OHE

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5
Q

What ovarian neoplasia have epithelial origins?

A

Adenoma

Adenocarcinoma

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6
Q

What ovarian neoplasia has Stromal orgins?

A

Granulosa cell tumor

Functional hormone producing tumor

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7
Q

What ovarian neoplasia has Germ cell origins?

A

Dysgerminoma

Teratoma

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8
Q

What are the clinical signs of the Granulosa cell tumor?

A

Persistent proestrus

Pyometra

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9
Q

How do you diagnose Ovarian Neoplasia?

A

Radiographs

Ultrasound

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10
Q

What is the treatment for Ovarian neoplasia?

A

Ovariectomy

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11
Q

What is the clinical sign for Ovarian Remnant Syndrome?

A

Recurrence of estrus following OHE/OVE

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12
Q

What is the etiology of Ovarian Remnant Syndrome?

A

Failure to remove all ovarian tissue

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13
Q

What is the treatment of Ovarian Remnant Syndrome?

A

Surgical Removal

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14
Q

What is the etiology of Cystic Endometrial Hyperplasia?

A

Associated with excess and prolonged progesterone

Growth/secretions of endometrial glands inhibiting Uterine drainage and fluid accumulation

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15
Q

Hydrometra

A

Water filled Uterus

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16
Q

Mucometra

A

Mucus filled Uterus

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17
Q

Hematometra

A

Blood filled Uterus

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18
Q

What are the clinical signs of Cystic Endometrial Hyperplasia?

A

Failure to conceive
Vaginal discharge
PU/PD

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19
Q

How do you diagnose Cystic Endometrial Hyperplasia?

A

Ultrasound

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20
Q

What is the treatment for Cystic Endometrial Hyperplasia?

A

OHE

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21
Q

Pyometra

A

Infection of the uterus

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22
Q

What is the most common bacteria in Pyometra?

A

E. Coli

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23
Q

What are the bacterial sources of Pyometra?

A

Ascending

Hematogenous

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24
Q

What are the clinical signs of Pyometra?

A

Lethargy
Vomiting
PU/PD
Vaginal Discharge

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25
Q

What is a complication of Pyometra associated with abdominal palpation?

A

Uterine Rupture

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26
Q

What are clinical pathology findings associated with Pyometra?

A 
Hypoglycemia 
Azotemia 
Anemia 
Leukocytosis 
Increased AST and alkaline phosphate
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27
Q

How do you diagnose Pyometra?

A

Ultrasound

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28
Q

How do you treat Pyometra?

A

Stabilize the patient

OHE

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29
Q

What should you avoid with treatment of pyometra?

A 
Avoid septic abdomen!
Do not delay surgery 
no pre-op cystocentesis  
Use non-crushing clamps on uterus 
Do not oversew uterine stump
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30
Q

Segmental Pyometra

A

Pyometra is secluded in segments

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31
Q

What is the prognosis for pyometra?

A

Low mortality without septic abdomen

Septic abdomen increased mortality rate

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32
Q

What are the indications for medical management of pyometra?

A

Not systemically ill
Open pyometra
High breeding value

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33
Q

What is the medical management for pyometra?

A

PGF 2-alpha

Antibiotics 10-14 days

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34
Q

What are the complications of medical management of pyometra?

A 
Abdominal pain 
Emesis
Tachycardia 
Dyspnea
Systemic deterioration
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35
Q

Metritis

A

Inflammation/infection of the uterus

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36
Q

What is the etiology of Metritis?

A

Dystocia
Devitalized uterus
Fetal/placental retention

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37
Q

What are the clinical signs for Metritis?

A 
Foul smelling reddish brown discharge 
Fever 
Anorexia 
Lethargy 
Decreased milk production
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38
Q

What must you do to a breeding bitch that has just recovered from pyometra to ensure she doesn’t get it again?

A

Get her pregnant and welp a litter

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39
Q

What is the treatment for Metritis?

A

Antibiotics

OHE

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40
Q

Uterine Torsion

A

Twisting of uterus along long axis

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41
Q

What is Uterine torsion associated with?

A

Dystocia
Pyometra
CEH

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42
Q

What are the clinical signs of Uterine Torsion?

A

Acute abdomen
Abdominal distension
Shock

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43
Q

What is the treatment for Uterine Torsion?

A

Supportive Care: Fluids and Analgesics

OHE

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44
Q

What should you not do with Uterine Torsion?

A

Detorse the uterus

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45
Q

Uterine Prolapse

A

Protrusion of uterine tissue outside vulva

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46
Q

What predisposes to Uterine Prolapse?

A

Complication of parturition/dystocia

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47
Q

What are the clinical signs of Uterine Prolapse?

A

Vaginal discharge
Straining
Licking affected area
Protruding mass

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48
Q

What is the treatment for Uterine Prolapse?

A

Manual reduction
OHE
Amputation of uterine horns and removal of ovaries

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49
Q

What is the etiology of Uterine Rupture?

A

Dystocia
HBC
Post c-section
Pyometra

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50
Q

What is the treatment for Uterine Rupture?

A

OHE

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51
Q

What is the treatment for Uterine Neoplasia

A

OHE

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52
Q

What is the common uterine neoplasia of cats?

A

Adenocarcinoma

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53
Q

What is the common Uterine Neoplasia of Dogs?

A

Leiomyoma

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54
Q

Dystocia

A

inability to expel a fetus through the birth canal

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55
Q

What are the causes of Dystocia?

A 
Primary or secondary uterine inertia
Birth canal obstruction 
Fetal Malposition 
Fetal Malformation 
Fetus oversized
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56
Q

Primary Uterine Inertia

A

Parturition fails to proceed due to oversized litters or undersized litters

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57
Q

What is the clinical signs of Primary Uterine Inertia?

A

Prolonged gestation greater than 68 days

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58
Q

What is the gestation length of a dog?

A

63 days

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59
Q

Secondary Uterine Inertia

A

Normal delivery of part of litter and then develops uterine fatigue due to Fetal obstruction, Pelvic obstruction, Fetal malposition, or fetal size

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60
Q

What are the clinical signs of Secondary Uterine Inertia?

A

Prolonged interval between neonates (greater than 4 hours)

Weak or absent uterine contractions

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61
Q

How do you diagnose Dystocia?

A

Radiographs

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62
Q

What is the treatment for Primary Uterine Inertia?

A

Oxytocin
Manual manipulation of the fetus
c-section

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63
Q

What is the signalment for an animal with secondary uterine inertia?

A

middle aged dogs that have a large litter that are exhausted

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64
Q

What will happen if you give Oxytocin to an animal with secondary uterine inertia?

A

Uterine rupture

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65
Q

What are the indications for a c-section?

A 
Secondary uterine inertia
Primary uterine inertia refractory to treatment 
Systemic signs in bitch 
Fetal distress
Planned for high risk patients
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66
Q

What is the poster child for planned C-sections?

A

Bulldogs

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67
Q

What are the advantages of En block Resection?

A 
OHE
Dystocia treatment 
Decreased anesthesia time 
Decreased abdominal contamination 
No increased fetal mortality
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68
Q

What should you check the puppies for when you perform a c-section?

A

Cleft palate

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69
Q

How many mammary glands does the canine have?

A

5 paired glands

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70
Q

What arteries supply the mammary glands of the canine?

A

Lateral thoracic

Superficial epigastric

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71
Q

What Lymph nodes drain the mammary glands in the canine?

A

Axillary

Inguinal

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72
Q

How many mammary glands do felines have?

A

four paired glands

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73
Q

What is the most common mammary tumor of the feline?

A

Adenocarcinoma

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74
Q

How do you prevent mammary tumors in canine and feline?

A

Early Ovariectomy or OHE

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75
Q

What is the surgical procedure for treatment of canine mammary tumors?

A

Lumpectomy
Mastectomy
Regional mastectomy
full chain mastectomy

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76
Q

What is the surgical procedure for the treatment of feline mammary tumors?

A

Full chain mastectomy

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77
Q

What are the risk factors for canine mammary tumors?

A

OHE before 2nd estrus or after 2 years of age
Obesity before 1 year of age
Administration of progestins
Presence of benign tumors

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78
Q

What is the most common malignant mammary tumor of dogs?

A

Carcinoma

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79
Q

Carcinosarcoma

A

mixed malignant mammary tumor

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80
Q

How do you diagnose metastasis with mammary tumors?

A

3 radiographic views

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81
Q

How do you diagnose mammary tumors?

A

Thoracic radiographs
Abdominal ultrasound
Excisional biopsy
Cytology

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82
Q

What is the criteria of Malignancy (COM) for mammary tumors?

A 
Rapid growth 
Size greater than 1 cm 
Fixed to skin or fascia 
Poorly circumscribed 
Ulcerated or inflammation
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83
Q

When should you not resect a mass?

A

Inflammatory carcinoma

Presence of distant metastasis

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84
Q

Lumpectomy

A

removal of tumor only

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85
Q

Simple or local mastectomy

A

removal of tumor and its gland of origin

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86
Q

Reginal mastectomy

A

removal of 2 or more glands with associated lymphatic structures

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87
Q

Full chain (radical) mastectomy

A

removal of entire chain and associated lymphatic structures

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88
Q

Unilateral mastectomy

A

tumor confined to one mammary chain

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89
Q

Staged bilateral mastectomy

A

6 week interval between surgeries

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90
Q

What procedure would you perform on a small freely movable mass on periphery of gland?

A

Lumpectomy

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91
Q

What procedure would you perform on a mass central in the gland?

A

Simple mastectomy

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92
Q

What procedure would you perform on a mass in both inguinal glands on one side?

A

Regional mastectomy

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93
Q

What procedure would you perform on moasses in cranial and caudal glands?

A

Multiple simple mastectomy

Chain mastectomy

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94
Q

What are the indications for a Lumpectomy?

A

Small tumors less than 5 cm
Known to be benign
Mass between glands or near edge

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95
Q

What are the contraindications for a Lumpectomy?

A

Any COM

Mass middle of gland

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96
Q

What are the indications for a simple Mastectomy?

A

Larger fixed solitary tumors 1-2 cm

Centrally located

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97
Q

What are the contraindications for a Simple Mastectomy?

A

More than one COM

Mass greater than 2 cm

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98
Q

What are the indications for a Regional Mastectomy?

A

Larger tumors

Multiple tumors

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99
Q

If you have tumors in glands 1 and 2 which glands do you remove?

A

Glands 1,2,and 3

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100
Q

If you have tumors in glands 4 and 5 which glands do you remove?

A

Glands 3,4,and 5

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101
Q

If you have tumors in glands 3 what do you perform?

A

Chain mastectomy

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102
Q

What are the indications for Chain Mastectomy?

A

Multiple masses throughout chain

Tumors in gland 3 in which lumpectomy or simple mastectomy is not appropriate

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103
Q

What is postoperative care for Mammary tumor removal?

A

Sterile pressure bandage over drain and incision
Remove drain at 2-5 days
Analgesics

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104
Q

What are the complications associated with Mammary tumor removal?

A

Post-operative pain
seroma
Dehiscence - bilateral mastectomy

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105
Q

What kind of adjunct therapy is associated with mammary tumors?

A

Radiation
Estrogen therapy
Chemotherapy in combo with surgery

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106
Q

Canine Mammary Hyperplasia

A

Rapid development of small multiple masses after heat cycle

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107
Q

How do you differentiate Canine Mammary Hyperplasia from Mammary tumors?

A 
Slower onset 
Not associated with heat cycle 
More defined
Does not affect all glands 
Often Painful
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108
Q

Fibroadenomatous Hyperplasia in cats

A

Benign mammary lesion in cats causing Rapid proliferation and mammary gland enlargement

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109
Q

What is the treatment for Fibroadenomatous Hyperplasia in Felines?

A

OHE/OVE

Consider Flank approach

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110
Q

Episiotomy

A

Incision through perineal body to approach caudal vagina

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111
Q

When would you perform a Episioplasty?

A

Treatment for perivulvar drematitis

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112
Q

When would you perform a Vaginectomy?

A

treatment for vaginal hypoplasia, intrapelvic annular stenosis

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113
Q

Septal Stenosis

A

Band of tissue oriented dorsoventrally to create a double vagina

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114
Q

What is the treatment for Septal Stenosis?

A

Episiotomy
Mucosal resection at attachments
Suture mucosa
Laser Ablation

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115
Q

Vaginal edema/Hyperplasia

A

Vaginal tissue becomes severely edematous and protrudes from the vulva

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116
Q

What is the medical treatment for Vaginal Hyperplasia/Prolapse?

A

Keep tissue clean, prevent self mutilation
Will resolve at the end of estrus
Gonadotropin releasing hormone or HCG will induce ovulation and shorten estrus
Ovariectomy prevents recurrence

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117
Q

What is the surgical treatment for Vaginal Hyperplasia/Prolapse with healthy tissue?

A

reduce prolapsed tissue, place mattress suture across lips of vulva
Ovariectomy

118
Q

What is the surgical treatment for Vaginal Hyperplasia/Prolapse with Damaged tissue?

A

resect prolapsed tissue at base via episiotomy

Ovariectomy

119
Q

How do you treat Vaginal Prolapse?

A

Manual reduction

OHE

120
Q

What is the most common benign Vaginal Neoplasia in dogs?

A

Leiomyoma

121
Q

What is the most common malignant vaginal neoplasia in dogs?

A

Leiomyosarcoma

122
Q

What is the treatment for Benign Vaginal Tumors?

A

Local resection via episiotomy

OHE

123
Q

What is the treatment for Malignant Vaginal tumors?

A

Aggressive resection with wide borders
Vulvovaginectomy
perineal urethrostomy

124
Q

How do you treat TVT?

A

Medically

125
Q

Episioplasty

A

Reconstructs procedure that excises skin folds around the vulva and draws the labia caudally

126
Q

What is a predisposing factor to a recessed vulva?

A

Overweight dogs

Early OHE

127
Q

Anorchism

A

Absence of both testicles

128
Q

Monorchism

A

Absence of one testicle

129
Q

Cryptorchism/Cryptorchidism

A

One or both testicles not descended into scrotum

Developmental problems with gubernaculum

130
Q

When do testicles usually descend?

A

30-40 days

131
Q

At what age would we classify an animal cryptorchid?

A

6 months

132
Q

How do you classify Cryptorchidism?

A

Location
Side
Type

133
Q

What Cryptorchidism is common in dogs?

A

Unilateral Cryptorchidism

134
Q

Characteristics of the Cryptorchid Testicle

A

Sterile
Suppresses spermatogenesis in normal testicle
Predisposed to neoplasia
Predisposed to torsion

135
Q

What kind of castrations would you preform on a Inguinal Cryptorchid?

A

Open Castration

136
Q

What approach would you make for an Abdominal Cryptorchid?

A

Caudal Paramedian abdominal approach or a ventrla midline

137
Q

What are the clinical signs of Testicular torsion?

A 
Anorexia 
Lethargy
Acute abdomen 
Shock 
Death
138
Q

What are the 3 types of Testicular Neoplasia?

A

Interstitial cell
Sertoli cell
Seminoma

139
Q

Characteristics of Sertoli cell tumors

A 
Estrogen producing 
Feminization 
Bilateral symmetrical alopecia 
Gynecomastia
Penile atrophy 
Squamous metaplasia of prostate 
prostatic cysts 
Anemia 
Leukopenia 
Low metastatic rate
140
Q

Characteristics of Interstitial cell tumor

A

Testosterone producing

141
Q

What is the treatment for testicular neoplasia?

A

Castration/scrotal ablation

142
Q

What are the indications for Scrotal Ablation?

A

Neoplasia
Infection
Trauma
Castraton of older large breed dogs

143
Q

How would you treat a fracture of os penis?

A

Catheterize urethra with conservative management

If comminuted can wire or finger plate

144
Q

What is the treatment for Trauma or strangulation of the penis?

A

Conservative Management
Catheterize if urethral trauma
Penile amputation if necrotic

145
Q

What are the indications of Penile Amputation?

A

Gangrenous penis

Severe urethral trauma

146
Q

What are the different types of Penile/preputial tumors?

A 
Papilloma
SCC
osteosarcoma
MCT
TVT
147
Q

What is the treatment for TVT?

A

Vincristine

148
Q

What is the treatment for Penile/preputial tumors?

A

Surgical resection or partial penile amputation

149
Q

Paraphimosis

A

Inability to retract penis into prepuce

150
Q

What are the congenital causes of Paraphimosis?

A

Narrow orifice

Shortened prepuce

151
Q

What are the acquired causes of Paraphimosis?

A

Trauma
Infection
Priapism
Neoplasia

152
Q

What is the treatmenrt for Paraphimosis?

A

Lubricants and hyperosmolar agents
Preputiotomy
Preputial advancement

153
Q

How do you treat recurrent/persistent paraphimosis?

A

Phallopexy

Penile amputation if necrotic

154
Q

Phimosis

A

inability to protrude penis beyond preputial orifice

155
Q

What is the cause of congenital Phimosis?

A

Distended prepuce

156
Q

What is the cause of acquired phimosis?

A

Preputial trauma

Neoplasia

157
Q

What are the clinical signs of Phimosis?

A

Unusual urine streams

Balanoposthitis from retention of urine

158
Q

What is the treatment for Phimosis?

A

Enlarge preputial orifice

Surgically shorten prepuce

159
Q

What are the clinical signs of Benign Prostatic Hyperplasia?

A

Asymptomatic
Dyschezia
Ribbon-like feces

160
Q

What is the treatment for Benign Prostatic Hyperplasia?

A

Castration

161
Q

What is the cause of Prostatitis/Abscess?

A

Ascending infection via urethra

Hematogenous

162
Q

What are the clinical signs of Prostatitis/Abscess?

A

Dyschezia
Painful urination
Purulent discharge

163
Q

How do you treat mild cases of Prostatitis/Abscess?

A

Castration

Systemic antibiotics: Enrofloxacin or TMS

164
Q

How do you treat severe cases of Prostatitis/Abscess?

A

Supportive care
Systemic Antibiotics
Prostatic drainage
Castration

165
Q

What is a procedure for Prostatic Drainage?

A

Ometalization

166
Q

Prostatic Cysts

A

Accumulation of glandular secretions within the prostate

167
Q

What are Prostatic Cysts associated with?

A

BPH

Hormonal imbalances

168
Q

What are the most common Prostatic cysts?

A

Parenchymal cysts

169
Q

How would you diagnose Prostatic cysts?

A 
Abdominal palpation 
Radiographs 
Contrast Radiographs 
Ultrasound 
FNA
170
Q

What are the treatments for Small cysts?

A

Surgical resection

Castration

171
Q

What are the large cysts or capsular/urethral communication?

A

Partial resection
Drainage
Omentalization
Castration

172
Q

What is the most common Prostatic Neoplasia?

A

Adenocarcinoma

173
Q

What are the clinical signs of Prostatic neoplasia?

A 
Dysuria
Hematuria 
Straining to defecate 
Ribbon-like feces 
Lameness due to metastasis 
Large symmetrical prostate
174
Q

What is the treatment for Prostatic Neoplasia?

A

Palliative: tube cystotomy or urethral stent
Partial prostectomy
Complete prostectomy
Radiation therapy

175
Q

What are the indications for a subtotal Prostatectomy?

A

Multilocular abscess
Recurrent abscesses
Neoplasia

176
Q

How do you treat Calcium oxalate?

A

No Medical Management

177
Q

What is the treatment criteria for Nephrolithiasis?

A

Type of calculi
Anatomical location
Clinical effects

178
Q

When would you perform surgery for Nephrolithiasis?

A

Obstruction

Infection associated with the calculi

179
Q

What approach do you take with Nephrolithotomy?

A

Ventral Midline celiotomy

180
Q

What are the closure options for the kidney?

A

Sutureless closure
Horizontal mattress
Nephropexy

181
Q

Pyelolithotomy

A

used to remove calculi when proximal ureter and renal pelvis are dilated

182
Q

What is the post operative management for a Pyelolithotomy?

A 
Post op radiographs 
Monitor PCV
CVP 
Monitor urine output 
Monitor renal enzymes/electrolytes 
Provide diuresis
183
Q

What is the treatment for minor trauma to the kidney?

A

Conservative treatment

184
Q

What is the treatment for moderate trauma to the kidney?

A

Surgery to repair

185
Q

What is the treatment for major trauma to the kidney?

A

Partial nephrectomy

Nephroureterectomy

186
Q

What are the indications for a Nephroureterectomy?

A 
Severe infection 
Severe trauma 
obstructive calculi with persistent hydronephrosis 
Neoplasia 
Transplant
187
Q

What are the indications for Partial Nephrectomy?

A

Trauma
Focal hemorrhage
neoplasia

188
Q

What is the purpose of the Partial Nephrectomy?

A

Preserves Renal function

189
Q

What is a disadvantage of a Partial Nephrectomy?

A

Higher incidence of post operative hemorrhage

190
Q

Hydronephrosis

A

Progressive dilation of the renal pelvis and atrophy of the renal parenchyma

191
Q

What are the acquired causes of Hydronephrosis?

A 
Neoplasia 
Abscess
cysts
stone 
iatrogenic
192
Q

What are the congenital causes of Hydronephrosis?

A

Torsion
Kinking
Stenosis
Atresia

193
Q

When would you perform a Nephroureterectomy for Hydronephrosis?

A

Non functional or severe parenchymal damage

194
Q

Pyelonephritis

A

Ascending infection of the kidney

195
Q

What would you treat advanced Pyelonephritis with?

A

Nephrouretectomy

196
Q

What is the treatment for the Giant Kidney Worm?

A

Nephrectomy

Nephrotomy

197
Q

What is the most common benign neoplasia of the kidney?

A

Renal Adenoma

198
Q

What are primary tumors of the kidney?

A

Renal cell carcinoma
TCC
Nephroblastoma

199
Q

What are some metastatic tumors of the kidney?

A

Lymphosarcoma
Hamngiosarcoma
SCC

200
Q

What is the most common renal neoplasia of dogs?

A

Renal Cell carcinoma

201
Q

How would you treat Renal cell carcinoma?

A

Nephroureterectomy and chemotherapy

202
Q

What is the most common renal neoplasia of cats?

A

Renal lymphoma

203
Q

Embryonic Nephroblastoma

A

Congenital neoplasia common in young dogs and cats

204
Q

What are the clinical signs of Renal neoplasia?

A 
Hematuria 
Abdominal distension 
Anorexia 
Weight loss
Depression 
Abdominal pain
205
Q

How do you treat nephroblastoma?

A

Exploratory Laparotomy

Unilateral Nephroureterectomy

206
Q

What are the indications for Renal Biopsy?

A

Suspected neoplasia
Nephrotic syndrome
Renal cortex disease
Non diagnosed ARF

207
Q

What are the contraindications for Renal biopsy?

A

Coagulopathies
Hypertension
Severe chronic hydronephrosis

208
Q

What are the complications associated with Renal biopsy?

A

Severe hemorrhage
Hematuria
Hydronephrosis

209
Q

What are the indications for Renal transplant?

A

Irreversible acute renal failure
Decompensated chronic renal failure
Polycystic disease

210
Q

Ectopic Ureter

A

Failure of one or both ureters to terminate in the normal location

211
Q

What abnormalities is Ectopic Ureter associated with?

A

Hydroureter
Small/absent kidney
Pelvic bladder

212
Q

What are the clinical signs of Ectopic Ureter?

A

Incontinence
Fails to house train
UTI
Urine Scalding

213
Q

How do you diagnose Ectopic ureter?

A

Excretory urography

214
Q

Extramural Ectopic Ureter

A

Enters into neck, urethra, or vagina

215
Q

Intramural Ectopic ureter

A

Enters normally but exits abnormally

216
Q

What is the most common ectopic ureter in dogs?

A

Intramural ectopic ureter

217
Q

How do you treat ectopic ureter?

A

Neoureterocystostomy (end to side)
Neoureterocystostomy (side to side)
Laser transection of wall between EU and bladder or urethra

218
Q

Ureterocele

A

Dilation of distal ureter due to persistent membrane in embryonic development

219
Q

How do you diagnose Ureterocele?

A

IV urography

Ultrasonagraphy

220
Q

What is the sign on IV urography for a Ureterocele?

A

Cobra head sign

221
Q

What is the treatment for Intravesicular Ureterocele?

A

Ureterocelectomy

222
Q

What is the treatment for Ectopic Ureterocele?

A

Neoureterocystostomy with urterocelectomy

223
Q

What is the treatment for Ureteral Trauma?

A

Nephroureterectomy
Ureteroureterostomy
Neoureterocystostomy
Urinary diversion

224
Q

When would you perform a Ureteroureterostomy?

A

Procedure of choice for the proximal ureter

225
Q

What are the indications for Urinary diversion with a Nephrostomy tube?

A

ureter surgery
hydronephrosis
obstruction

226
Q

When would you perform a Transureteroureterostomy?

A

when proximal ureteral length is insufficient to reach the bladder but long enough to cross midline

227
Q

What do you perform when you have loss of ureter length?

A

Renal Descensus
Nephrocystopexy
Psoas Hitch

228
Q

Renal Descensus

A

Mobilize kidney and suture caudally to lumbar musculature

229
Q

Nephrocystopexy

A

Suturing the kidney to the cranial edge of the bladder

230
Q

Psoas Hitch

A

Fixed the bladder in a more cranial position

231
Q

When would you perform a Bladder wall flap?

A

significant loss of distal ureter

232
Q

What is the most common indications for ureteral surgery?

A

Ureterolithiasis

233
Q

What is medical management for Ureterolithiasis?

A

IV fluids
diuretics
Smooth muscle relaxers

234
Q

What are indications for Surgery for Urolithiasis?

A

Complete obstruction
Azotemia
Pyelonephritis

235
Q

What is the treatment for Urolithiasis?

A

Cystotomy and retrograde flushing and removal via pyelithotomy
Ureterotomy

236
Q

What are the advantages of Permanent Ureteral Stenting?

A

Decreased morbidity
Shorter hospitalization
Less complcations

237
Q

What are the disadvantages of Permanent Ureteral Stenting?

A

Specialized equipment

Steep learning curve

238
Q

What are the indications for permanent ureteral stenting?

A

Stone
Tumor
Stricture
Blood clot

239
Q

What ligament of the bladder should be avoided with surgery?

A

Lateral Ligaments

240
Q

What nerve provides sympathetic innervation to the bladder?

A

Hypogastric n.

241
Q

What nerve provides parasympathetic innervation to the bladder?

A

Pelvic n.

242
Q

What provides blood supply to the bladder?

A

Caudal vesicular

Prostatic/vaginal Art.

243
Q

Persistent Urachus

A

Persistent connection from the bladder to the umbilicus through a patent urachal canal

244
Q

What are the clinical signs of a Patent urachus?

A

Urine dribbling from umbilicus
Omphalitis
Ventral abdomen dermatitis
UTI

245
Q

Wht is the treatment for Perisistent Urachus?

A

Surgical removal of urachal tube

246
Q

Vesicourachal Diverticulum

A

External opening is closed but the bladder attachment is still patent

247
Q

How do you treat Vesicouracheal Diverticulum?

A

Partial cystectomy

Diverticulectomy

248
Q

Urachal Cyst

A

secreting urachal epithelium persists

249
Q

Urachal sinus

A

Persistent distal urachas remains open

250
Q

How do you treat Urachal sinus?

A

Surgical excision

251
Q

What causes Bladder Rupture?

A 
Trauma 
Severe cystitis
Neoplasia 
Urethral obstruction 
Iatrogenic
252
Q

What is the most reliable way to Diagnose Bladder Rupture?

A

Positive contrast urethrocystogram

253
Q

How do you treat Bladder Rupture?

A

Stabilize patient!
Urinary diversion
Exploratory Laparotomy

254
Q

What are the indications for Cystopexy?

A

Tube Cystotomy
Perineal hernia
Urinary incontinence

255
Q

What a very common disease of the bladder?

A

Cystic Calculi

256
Q

What is the most common cystic calculi?

A

Struvites

257
Q

What are the Non surgical treatments for Cystic calculi?

A

Hydropropulsion
Transurethral cystoscopy
Dietary modification
Electrohydraulic Lithotripsy

258
Q

What is the most common surgery of bladder?

A

Cystotomy

259
Q

What are the indications for Cystotomy?

A

Urinary tract obstruction
no medical options
other retrieval methods have failed

260
Q

What is the preferred approach for a Cystotomy?

A

Ventral

261
Q

What is the layer of strength for the bladder?

A

Submucosa

262
Q

What suture should you not use on a cystotomy?

A

Braided suture if infection is present

263
Q

What is the treatment for polypoid cystitis?

A

Surgery

264
Q

What is the most common bladder tumor in Felines?

A

Transitional cell carcinoma

265
Q

Where is the most common site in the dog for Transitional cell carcinoma?

A

Trigone area

266
Q

What are the predisposing factors for TCC?

A

Obesity
Insecticide exposure
Herbicide
Cyclophosphamide

267
Q

What is diagnostic for TCC?

A

Cystoscopy

268
Q

What is the most sensitive method of diagnosis for TCC?

A

Ultrasound

269
Q

What is the treatment for TCC?

A

Partial cystectomy
if in the trigone area then a Ureterocolonic anastomosis or Ureterouterine anastomosis
Chemotherapy

270
Q

Hypospadias

A

Incomplete formation of penile urethra

271
Q

Urethral Prolapse

A

Protrusion of urethral mucosa through orifice

272
Q

What is the signalment for Urethral Prolapse?

A

Young male brachycephalic dogs

273
Q

What is the treatment for Mild Urethral Prolapse?

A

Reduce and purse string
Urethropexy
Castration

274
Q

What is the treatment for severe urethral prolapse?

A

Resection and anastomosis

275
Q

What is the complication for urethral surgery?

A

becomes edematous easily

276
Q

What is the goals of treatment for urethral obstruction?

A

Renal function/uremia
Electrolytes
Relieve obstruction: Catheter, Hydropulsion, or cystocentesis
Treat UTI

277
Q

Retrograde Hydropropulsion

A

injection of saline into the urethra that distends the urethra and propulses the stone into the bladder

278
Q

What is the surgical treatment for urethral obstruction?

A

Cystotomy after hydropropulsion
Urethrotomy
Urethrostomy

279
Q

What are the indications for a Urethrostomy in the dog?

A

Calculi that cannot be hydrpropulsed

280
Q

Urethrotomy

A

creating temporary opening into urethra

281
Q

When would you perform a Perineal Urethrotomy in dogs?

A

when calculi are lodged between scrotum and ischial arch

282
Q

Urethrostomy

A

forming a permanent opening of the urethra at a new site

283
Q

When would you perform a Urethrostomy?

A

Permanent damage
Recurrent urethral obstruction
obstruction that cannot be retropulsed or removed by urethrotomy

284
Q

When would you perform an Antipubic Urethrostomy?

A

when there is no distal urethra left

285
Q

What are the complications of the Urethrostomy?

A 
Hemorrhage 
Dehiscence
Urine scald
Stricture 
UTI
286
Q

What procedure has a high incidence of Urine Scald as a complication?

A

Prescrotal urethrostomy

287
Q

What are the indications for Perineal Uretherostomy in a cat?

A

Frequent obstructions
Strictures
Trauma

288
Q

Name a salvage procedure used to treat Feline Lower Urinary tract Disease Syndrome and calculi in male cats?

A

Perineal Urethrostomy

289
Q

What are the complications associated with Perineal Urethrostomy?

A 
Hemorrahge 
Urinary tract infection 
Stricture 
Subcutaneous urine 
Perineal hernia 
Urinary incontinence 
Urethrorectal fistula
290
Q

Antpubic urethrostomy

A

Creation of a urethrostomy on the ventral body wall cranial to the pubis

291
Q

What are the indications for Antepubic urethrostomy?

A

Recurrent pelvic urethral obstruction

Failed perineal urethrostomy that cannot be revised

292
Q

What are the complications associated with Antepubic Urethrostomy?

A

Urine scald
UTI
Incontinence

RUSVM Small Animal Surgery 2017 (17 decks)

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