Page 231 - Manual of Equine Field Surgery

Urethral Extension (Urethroplasty) 227

dures.i? Short-term complications such as dehis-
I

cence or fistula formation are reported to occur in

• 3•5
11 o/o to 15% of all described techniques. When

complications arise, subsequent surgeries are essen-

J
tial to improve the chances for complete healing.

Postoperative conception rates are reported to be

64% to 92% within 1 year postoperatively= Recur-

rence of urovagina is uncommon, unless a signifi-

cant change in perineal conformation occurs.

COMPLICATIONS

Suture dehiscence and fistula development along

the suture line are the most common cornplica-

tions. Fistula development is most commonly

observed at the junction of the transverse urethral

.. t
fold and vaginal wall reflexion. These complica-

tions can be avoided by precise dissection, metic-
< 'i
i I
ulous suture placement, and reduced tension

on apposed tissues. If a fistula develops, an

~¢,.-~~
attempt to repair the fistula should be pursued to

Figure 41-13 The second suture line begins on the minimize the risk of endometritis, persistent

opposite side in the same manner, continuing caudally urovagina, and infertility.

ending at tl1e caudal edge of the vagina wall. The com- Leaving the indwelling urinary catheter in

pleted urethral extension is in the shape of a Y, with the place for longer than 3 days may result in cystitis.

base of the Y pointing caudal.
If cystitis does occur, the catheter is removed, the

urine is cultured, and appropriate antimicrobials

POSTOPERATIVE CARE are administered until bacteria are no longer

isolated.3

Postoperative Care

Exercise Restridions: Small-paddock turnout REFERENCES

should be maintained for 30 days.

Medications: Broad-spectrum antibiotics are

administered for 7 to 10 days. A nonsteroidal anti- 1. Beard W: Standing urogenital surgerv. Vet Cli11. N Am

inflammatory agent is administered for 3 to 5 days. Equine Pract 7:669, 1991.

Catheter Removal: Mares should be monitored 2. Baird AN: Surgical management of urovagina in the

closely to determine their ability to urinate ade- mare, Southwest Vet 38:36, 1987.

quately. The Foley catheter is removed within 3 3. Brown MP, Calahan PT, Hawkins DL: Urethral

days postoperatively. extension for treatment of urine pooling in mares, J

Other: The reproductive tract should not be Am Vet Med Assoc 173:1005, 1978.

examined for 2 to 4 weeks after surgery, and 4. Shires GM, Kaneps AJ: A practical and simple surgi-

the mare should have 45 to 60 days of sexual cal technique for repair of urine pooling in the mare,

rest. Proc Am Assoc Equine Pract 32:51, 1986.
5. McKinnon AO, Belden JO: A urethral extension

technique to correct urine pooling (vesicovaginal
EXPECTED OUTCOME reflux) in mares, J Am Vet Med Assoc 192:647, 1988.

6. Easley JK: Diagnosis and treatment of vesicovaginal

Primary healing is reported to occur in appro- reflux in the mare, Vet Clin N Am Equine Pr act 4:407,

ximately 85% to 89°/o of urethroplasty proce- 1988.