Page 230 - Manual of Equine Field Surgery

226 FEMALE UROGENITAL SURGERIES '

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Figure 41-10 Caudal retraction of the transverse

urethral fold allowing an incision to be made into the Figure 41-11 Caudal reflection of the transverse

transverse urethral fold. The proposed incision is urethral fold and axial reflection of the vaginal wall

shown with dotted lines. The incision should end at the mucosa after dissection.

vulvar labia half to two thirds of the distance between

the vaginal floor and roof.

allow 3 to 6 cm of caudal reflection, while the

vaginal wall tissues are reflected past midline

without tension (Figure 41-11). The final config-

uration is in the shape of a Y, with the base of the

Y caudal. Beginning at the right cranial junction

of the transverse fold and vaginal wall incision,

reflected tissues are apposed with No. 2-0 ab-

sorbable suture using a Connell pattern, ending

at the midpoint of the transverse urethral fold

reflection (Figure 41-12). The second suture line

is performed on the left side in the same manner,

continuing caudally ending at the caudal edge of

reflected vaginal wall (Figure 41-13). It is impor-

tant to maintain minimal suture tension on the

suture line and invert all tissue edges. Exposed

submucosal tissues created dorsally by transverse

fold and vaginal mucosal dissection are allowed to ~S·~,;t.;,,;:4:,.._ ,
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heal by second intention. Figure 41-12 The reflected transverse urethral fold

Whe11 indicated, a Caslick's procedure is per- and vaginal wall are apposed using a Connell pattern

formed after all urethroplasty techniques. beginning at their cranial junctions.