Kieves Nina R, Novo Roberto E, Martin Robert B
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108, USA.
J Am Vet Med Assoc. 2011 Oct 1;239(7):972-80. doi: 10.2460/javma.239.7.972.
CASE DESCRIPTION-4 dogs were evaluated because of recurrent urinary tract infections. CLINICAL FINDINGS-All dogs had recurrent urinary tract infections and similar clinical signs; 3 dogs had urinary incontinence. Digital vaginal examination revealed vestibulovaginal stenosis in all dogs, which was confirmed by results of contrast vaginourethrography. From image measurements, the vestibulovaginal ratio (ratio of the height of the vestibulovaginal junction to the maximum height of the vagina on a lateral vaginourethrogram) was calculated for each dog. Three dogs had severe stenosis (vestibulovaginal ratio, < 0.20; severe stenosis is defined as a vestibulovaginal ratio < 0.20), whereas the fourth dog had moderate stenosis (vestibulovaginal ratio, 0.24; ratio range for moderate stenosis is 0.20 to 0.25). TREATMENT AND OUTCOME-All dogs were anesthetized for surgical correction of the vestibulovaginal stenosis. Vaginal resection and anastomosis of the stenosis was performed in all 4 dogs, with 1 dog also undergoing episioplasty. Complete resolution of clinical signs was apparent in 3 dogs; 1 dog had postoperative complications including pollakiuria and stranguria, which resulted in rectal and vaginal prolapse. This dog underwent ovariohysterectomy, after which clinical signs resolved. All dogs had resolution of urinary tract infections at the time of follow-up (6 to 8 months after surgery). CLINICAL RELEVANCE-Resection and anastomosis may resolve recurrent urinary tract infections in dogs with severe or moderate vestibulovaginal stenosis. Episiotomy was not necessary for success of surgical treatment, and overall, that procedure increased morbidity, the severity of intraoperative hemorrhage, and duration of surgery.
病例描述 - 4只犬因反复发生尿路感染接受评估。临床发现 - 所有犬均有反复尿路感染及相似的临床症状；3只犬存在尿失禁。指检阴道检查发现所有犬均有前庭阴道狭窄，阴道尿道造影结果证实了这一点。根据图像测量，计算每只犬的前庭阴道比值（侧位阴道尿道造影上前庭阴道交界处高度与阴道最大高度之比）。3只犬有严重狭窄（前庭阴道比值<0.20；严重狭窄定义为前庭阴道比值<0.20），而第4只犬有中度狭窄（前庭阴道比值为0.24；中度狭窄的比值范围为0.20至0.25）。治疗及结果 - 所有犬均接受麻醉以进行前庭阴道狭窄的手术矫正。所有4只犬均进行了阴道狭窄切除及吻合术，1只犬还接受了会阴成形术。3只犬的临床症状完全缓解；1只犬术后出现并发症，包括尿频和排尿困难，导致直肠和阴道脱垂。这只犬接受了卵巢子宫切除术，术后临床症状缓解。随访时（术后6至8个月）所有犬的尿路感染均已消除。临床意义 - 切除及吻合术可能会缓解严重或中度前庭阴道狭窄犬的反复尿路感染。会阴切开术对于手术治疗的成功并非必要，总体而言，该手术增加了发病率、术中出血的严重程度及手术持续时间。
