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先天性尿道阴道瘘伴盲端阴道的雌性假两性畸形尿失禁犬

Congenital Urethrovaginal Fistula with Blind-Ending Vagina in a Female Pseudohermaphrodite Dog with Urinary Incontinence.

出版信息

J Am Anim Hosp Assoc. 2021 Aug 9;57(5). doi: 10.5326/JAAHA-MS-7114.

Abstract

An 8 mo old male Doberman pinscher was referred for investigation of persistent urinary incontinence. Physical examination revealed urine leakage and abnormal external genitalia. A computed tomography scan identified a large fluid-filled cavity extending from the caudoventral abdomen displacing the colon and urinary bladder. No retained testicles were identified. A retrograde urethrogram study found a linear communication, cranial to the pubic brim between the urethra to the fluid-filled cavity (fistula). Exploratory celiotomy was performed, and an entire female reproductive tract with a blind-ending vagina and a urethrovaginal fistula was found. En bloc gonad hysterectomy was performed, the fistula was transected, and a careful urethral reconstruction was performed. The urinary incontinence resolved immediately after surgery, and no complications were reported. Mild urinary incontinence recurred 4 days following patient discharge, and a urine bacterial culture was positive for Klebsiella spp. An antibiotic course was prescribed, and the incontinence fully resolved. Congenital urogenital abnormalities should always be considered in young animals presenting with urinary incontinence. Here, a young female pseudohermaphrodite dog with a naturally occurring congenital urethrovaginal fistula is described. Exploratory surgery was required for definitive diagnosis and surgical intervention yielded a good medium-term outcome with resolution of clinical signs.

摘要

一只 8 月龄雄性德国牧羊犬因持续性尿失禁而被转介进行检查。体格检查显示有尿液漏出和外生殖器异常。计算机断层扫描显示,一个充满液体的大腔从尾部向腹侧延伸,使结肠和膀胱移位。未发现有保留的睾丸。逆行尿道造影研究发现,耻骨联合上方的尿道与充满液体的腔(瘘管)之间存在线性沟通。进行了剖腹探查术,发现了一个完整的女性生殖道,带有盲端阴道和尿道阴道瘘。进行了整块性腺子宫切除术,切断瘘管,并进行了仔细的尿道重建。手术后尿失禁立即得到解决,没有出现并发症。在患者出院后 4 天,出现轻度尿失禁,尿液细菌培养显示克雷伯菌属阳性。开了一个疗程的抗生素,尿失禁完全缓解。在出现尿失禁的年轻动物中,应始终考虑先天性泌尿生殖异常。这里描述了一只患有自然发生的先天性尿道阴道瘘的年轻雌性假两性畸形犬。需要进行探查性手术以明确诊断,手术干预获得了良好的中期结果,临床症状得到了缓解。

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