Page 216 - Manual of Equine Field Surgery
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212                        MALE UROGENITAL SURGERIES






















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                                            Incision  site
                                                                                                                                                                                                                                                                    A





































                                                                                                                                                     B









                                                                                r










                                                                                                                                                       Figure  38-3  A, Postoperative  view of perineal  ure-


                                                                                                                                                       throtomy  in a gelding.  At the  center of the  incision  the


                                                                                                                                                       urinary  catheter  is visible within the urethral  lumen.  B,


                                                                                                                                                       Close-up  view of  a completed  perineal  urethrostomy.
                                        ~c_.:,:---_

                                                                                                                                                       The  second  layer of suture  is shown  depicting  simple


                             Figure 38-1  View of the hind quarters  of a gelding.                                                                     interrupted  sutures  between  the  urethral  mucosa  and


                            The interrupted  line  depicts  the approach  for perineal                                                                 the perineal  skin.


                             urethrotomy.


                                                                                --                                                                      POSTOPERATIVE CARE
                                                                               j

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                                                                                                                                                                                        .,
                                                                                                                                                                                        .
                                                                                                                                                                                         .,.
                                                                                                                                                           :Postoperative Care



                                                                                                                                                           Protedion  and  Cleaning:  The  surgery  site


                                                                                                                                                           should be kept clean, and petrolatum jelly is applied


                                                                                                                                                           to the perinea!  region and the medial  aspect of both


                                                                                                                                                           upper hind  limbs to prevent urine  scald.


                                                                                                                                                           Medications:  Broad-spectrum  systemic  antibi-

                                                                                                                                                           otics.and nonsteroidal antiinflammatory  medication


                                                                                                                                                           such  as  phenvlbutazone  are given  perioperatively


                                                                                                                                                           for 3 to  5 days.


                                                                                                                                                            Exercise  Restridions:  Stallions  need  to  avoid


                                                                                                                                                            sexual activity for 4 to  6 weeks.


                                                                                                                                                            Dietary Modifications:  Adding salt to the  feed,
                                                                                  ~~-                                                                       at  1 O/o  of the  horse's  diet,  may encourage  ti ink-
                                                                                                                                                                                                                                                          r


                                                                                                                                                            ing and  aid  in  preventing  recurrence  of urolithia-

                             Figure  38-2  Intraoperative  view, showing  perineal                                                                          sis.5


                             urethrotomy  of  a  gelding  with  a  urinary  catheter  in                                                                    Other: Hemorrhage  should  be monitored  for the


                             place.  The illustration  depicts the  incision  through  the                                                                  first 24  hours.  Dripping  of blood  from  the  incision


                             skin  and  subcutaneous  tissue  and between  the retrac-                                                                      and  terminal  hematuria  are  expected  for  up to  2


                             tor  penis  muscles. The  deep layer shown  at the  center                                                                     weeks  postoperatively.

                              of the  incision is the  bulbospongiosus  muscle.
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