Saylor Sarah E, Mathews Kyle G
Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, NC, United States.
Front Vet Sci. 2025 Jan 7;11:1469961. doi: 10.3389/fvets.2024.1469961. eCollection 2024.
There are a variety of surgical conditions impacting the canine vagina and vestibule that require access through a caudal approach. A standard vertical episiotomy involves making an incision beginning ventral to the anus and extending ventrally through the dorsal commissure of the vulva and into the lumen of the vestibule and distal vagina. The objective of this study was to determine if complex vaginal procedures could be performed via a transverse perineal approach, thus eliminating the need to incise and reconstruct the vulva as performed in a standard episiotomy, and to evaluate the feasibility of vaginal resection with vulvar-sparing vestibular urethrostomy using this transverse approach. Ten canine, female cadavers were obtained and randomly split into two equally sized groups. Cadavers in Group A ( = 5) had a vaginal resection-anastomosis cranial to the urethral papilla. Cadavers in Group B ( = 5) had a complete vaginectomy and vulvar sparing vestibular urethrostomy. Procedures for both groups were approached through a transverse perineal incision. Postoperatively, cadavers of both groups had right lateral pelvic radiographs taken with a calibration marker in the field. The distance between the location of the anastomosis (Group A) or vaginectomy site (Group B) and the skin incision was measured. The procedures in both Group A and Group B were successfully performed through a transverse perineal approach in all 10 cadavers. The mean transverse perineal incision length was 2.88 cm ± 0.49 cm, compared to a mean standard episiotomy length of 5.83 cm ± 0.79 cm. The mean distance between the location of the anastomosis (Group A) or vaginectomy site (Group B) and the skin incision measured on pre-contrast right lateral pelvic radiographs was 2.54 cm ± 0.34 cm. The results of this study confirm the feasibility of performing complex vaginal procedures through a transverse perineal approach. The described approach is shorter than the standard episiotomy, which may result in diminished discomfort and decreased surgical/anesthetic time. This approach also eliminates the need to reconstruct the vulva. Further evaluation in clinical patients is warranted.
有多种影响犬类阴道和前庭的外科病症需要通过尾侧入路进行处理。标准的垂直会阴切开术是从肛门腹侧开始做切口，向腹侧延伸穿过阴门背侧联合，进入前庭和远端阴道腔。本研究的目的是确定复杂的阴道手术是否可以通过横向会阴入路进行，从而无需像标准会阴切开术那样切开和重建阴门，并评估使用这种横向入路进行保留阴门的前庭尿道造口术同时切除阴道的可行性。获取了10只雌性犬类尸体，并随机分成两组，每组数量相等。A组（n = 5）的尸体在尿道乳头头侧进行阴道切除 - 吻合术。B组（n = 5）的尸体进行完全阴道切除术和保留阴门的前庭尿道造口术。两组手术均通过横向会阴切口进行。术后，两组尸体均拍摄了右侧骨盆X线片，视野中有校准标记。测量吻合部位（A组）或阴道切除部位（B组）与皮肤切口之间的距离。A组和B组的手术在所有10只尸体中均通过横向会阴入路成功完成。横向会阴切口的平均长度为2.88 cm±0.49 cm，而标准会阴切开术的平均长度为5.83 cm±0.79 cm。在术前对比的右侧骨盆X线片上测量的吻合部位（A组）或阴道切除部位（B组）与皮肤切口之间的平均距离为2.54 cm±0.34 cm。本研究结果证实了通过横向会阴入路进行复杂阴道手术的可行性。所描述的入路比标准会阴切开术短，这可能会减少不适并缩短手术/麻醉时间。这种入路还无需重建阴门。有必要在临床患者中进行进一步评估。
