Burdick Stacy, Berent Allyson C, Weisse Chick, Langston Cathy
Animal Medical Center, Department of Internal Medicine, 510 E 62nd St, New York, NY 10065.
J Am Vet Med Assoc. 2014 Apr 15;244(8):944-9. doi: 10.2460/javma.244.8.944.
To describe the technique and evaluate short- and long-term outcomes in female dogs after endoscopic-guided laser ablation (ELA) of various vestibulovaginal septal remnants (VVSRs).
Retrospective case series.
36 dogs.
Medical records of dogs with VVSRs that underwent ELA were retrospectively reviewed. All patients underwent complete cystourethrovaginoscopy for diagnosis and treatment. Endoscopic-guided laser ablation (with a holmium:yttrium-aluminum-garnet or diode laser) was used to transect the vaginal membrane. Patients with intramural ectopic ureters were concurrently treated with ELA of their ectopic ureters. Endoscopy was repeated 6 to 8 weeks after ELA of vaginal remnants in some patients, and the procedure sites were reassessed.
36 female dogs with persistent paramesonephric septal remnants (n = 19), vaginal septa (11), or dual vaginas (6) were included. Twenty-six dogs had urinary incontinence, 2 had recurrent UTIs, and 8 had both. Thirty of 36 (83%) dogs had concurrent ectopic ureters. Endoscopic-guided laser ablation was performed with holmium:yttrium-aluminum-garnet and diode lasers in 8 and 28 dogs, respectively. Five dogs had mild postoperative dysuria for < 24 hours. One patient developed a complication involving inadvertent laser perforation of the vaginal wall. There were no negative effects from this event, and the perforation was fully healed within 8 weeks. At the time of follow-up, all defects were fully healed with no sign of recurrence in the 18 (50%) patients reevaluated. There was a significant improvement in continence scores and a significantly decreased incidence of UTIs after ELA. The median follow-up time was 34 months (range, 8 to 57 months). CONCLUSIONS AND CLINICAL RELEVENCE: The results of the present study indicated that ELA provided an effective, safe, and minimally invasive treatment option for various VVSRs in dogs, avoiding the need for more invasive surgery.
描述内镜引导下激光消融（ELA）治疗雌性犬各种前庭阴道隔残余物（VVSRs）的技术，并评估其短期和长期疗效。
回顾性病例系列。
36只犬。
回顾性分析接受ELA治疗的VVSRs犬的病历。所有患者均接受完整的膀胱尿道阴道镜检查以进行诊断和治疗。采用内镜引导下激光消融（钬：钇铝石榴石或二极管激光）切断阴道隔膜。合并壁内异位输尿管的患者同时接受异位输尿管的ELA治疗。部分患者在阴道残余物ELA术后6至8周重复进行内镜检查，并重新评估手术部位。
纳入36只患有持续性副中肾隔残余物（n = 19）、阴道隔（11只）或双阴道（6只）的雌性犬。26只犬有尿失禁，2只犬有复发性尿路感染，8只犬两者皆有。36只犬中有30只（83%）合并异位输尿管。分别用钬：钇铝石榴石激光和二极管激光对8只和28只犬进行了内镜引导下激光消融。5只犬术后出现轻度排尿困难，持续时间<24小时。1例患者发生并发症，意外出现阴道壁激光穿孔。该事件未产生负面影响，穿孔在8周内完全愈合。随访时，在重新评估的18例（50%）患者中，所有缺损均完全愈合，无复发迹象。ELA术后，尿失禁评分有显著改善，尿路感染发生率显著降低。中位随访时间为34个月（范围8至57个月）。结论及临床意义：本研究结果表明，ELA为犬的各种VVSRs提供了一种有效、安全且微创的治疗选择，避免了更具侵入性的手术。
