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犬常规阴囊前入路睾丸切除术致医源性尿道损伤。

Iatrogenic Urethral Trauma During Routine Prescrotal Orchiectomy in a Dog.

机构信息

Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA.

Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA.

出版信息

Top Companion Anim Med. 2020 Aug;40:100435. doi: 10.1016/j.tcam.2020.100435. Epub 2020 May 11.

Abstract

A 6-month-old neutered male redbone coonhound was presented for a 2-day history of progressive subcutaneous swelling that began immediately following a routine prescrotal orchiectomy. Severe, fluctuant swelling and bruising of the ventral thorax, abdomen, scrotum, and right pelvic limb was apparent on examination. No evidence of an underlying coagulopathy was detected. Azotemia and hyperkalemia were noted on venous blood gas analysis. Analysis of the serosanguineous fluid obtained from the fluctuant swelling revealed a BUN, creatinine, and potassium that were severely elevated and consistent with urine extravasation. A retrograde contrast urethrogram was performed and revealed leakage of contrast at the level of the prescrotal urethra. The dog was taken to surgery and a 2-cm longitudinal urethral defect was noted at the level of the prescrotal incision. A scrotal ablation and urethrostomy was performed, and the dog recovered uneventfully. This case highlights the diagnostic workup of a case of subcutaneous urine extravasation secondary to a urethral laceration sustained during a routine prescrotal orchiectomy. Iatrogenic urethral trauma should be considered as a differential diagnosis in dogs presenting for subcutaneous swelling with a history of recent orchiectomy surgery.

摘要

一只 6 月龄已去势的雄性红色寻血猎犬,因阴囊切除术 2 天后出现进行性皮下肿胀而就诊。临床检查发现,其胸腹部、阴囊和右侧骨盆带出现严重波动的肿胀和瘀斑。未发现潜在的凝血功能障碍。静脉血气分析显示氮血症和高钾血症。对波动肿胀处采集的血清血性液体进行分析,发现 BUN、肌酐和钾严重升高,符合尿外渗的情况。进行逆行性对比尿道造影,发现对比剂在阴囊前尿道水平泄漏。随后,该犬接受手术,在阴囊切口水平发现 2cm 长的尿道纵向缺损。进行了阴囊消融和尿道造口术,该犬恢复顺利。本病例强调了阴囊前尿道切开术治疗去势犬隐睾症时发生尿道裂伤导致的皮下尿外渗的诊断方法。对有近期去势手术史、出现皮下肿胀的犬,应考虑医源性尿道创伤作为鉴别诊断。

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