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评估联合切除-吻合术和尿道固定术在犬尿道脱垂中的应用。

Assessment of Combined Resection-Anastomosis and Urethropexy in Dogs with Urethral Prolapse.

机构信息

From Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts (M.K.G., R.K.K.); and.

Angell Animal Medical Center, Boston, Massachusetts (M.G.).

出版信息

J Am Anim Hosp Assoc. 2024 Sep 1;60(5):179-187. doi: 10.5326/JAAHA-MS-7401.

Abstract

The literature regarding surgical repair of urethral prolapse in dogs is limited and associated with a high recurrence rate. We hypothesized that combined resection and anastomosis (R&A) with urethropexy would be associated with less recurrence of urethral prolapse compared with R&A alone. Medical records of dogs managed surgically for urethral prolapse were reviewed (2013-2023) from three tertiary care hospitals. Inclusion criteria included complete medical records, including surgery reports, short-term postoperative complications, and longer-term follow-up. Forty-six male dogs successfully met the inclusion criteria (16 castrated; 30 intact). Brachycephalic breeds were overrepresented (37/46, 80%). Surgical repair by R&A alone (n = 27), urethropexy alone (n = 6), or a combined R&A and urethropexy (n = 13) was performed. Recurrence rates for these techniques were 13/27 (48%), 2/6 (33%), and 1/13 (8%), respectively. The recurrence rate of urethral prolapse treated by a combined R&A and urethropexy was significantly lower (P < .05) than R&A alone, despite more dogs being overweight and less surgeon experience (each P < .05). Interestingly, dogs neutered before initial diagnosis may be more likely to have postoperative recurrence. Considering general anesthesia risks, an initial combination procedure for urethral prolapse may help prevent recurrence.

摘要

关于犬尿道膨出的手术修复的文献有限,且复发率较高。我们假设与单独的 R&A 相比,联合切除和吻合术(R&A)与尿道固定术(urethropexy)相关的尿道膨出复发率更低。从三家三级护理医院回顾了接受尿道膨出手术治疗的犬的病历(2013-2023 年)。纳入标准包括完整的病历记录,包括手术报告、短期术后并发症和长期随访。46 只雄性犬成功符合纳入标准(16 只去势;30 只未去势)。短头犬品种占比过高(37/46,80%)。单独进行 R&A(n = 27)、单独进行尿道固定术(n = 6)或联合进行 R&A 和尿道固定术(n = 13)的手术修复。这些技术的复发率分别为 13/27(48%)、2/6(33%)和 1/13(8%)。尽管超重的犬更多且手术医生经验更少(均 P <.05),但联合 R&A 和尿道固定术治疗的尿道膨出的复发率明显低于单独 R&A(P <.05)。有趣的是,最初诊断前接受绝育的犬可能更有可能发生术后复发。考虑到全身麻醉的风险,尿道膨出的初始联合手术可能有助于预防复发。

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