Okkens A C, Kooistra H S, Nickel R F
Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, University of Utrecht, The Netherlands.
J Reprod Fertil Suppl. 1997;51:227-31.
Although ovariectomy is less invasive and less time-consuming than ovariohysterectomy, most surgical textbooks recommend ovariohysterectomy for routine neutering of bitches. This advice is probably based on concerns about the development of uterine disease after ovariectomy. However, there is no evidence that conditions such as cystic endometrial hyperplasia (CEH)-endometritis develop in the ovariectomized bitch, unless progestagens are administered. The purpose of this study was therefore to compare the long-term effects of ovariectomy and ovariohysterectomy, including the incidence of urinary incontinence. Questionnaires were sent to 264 owners of bitches, in which ovariectomy (126) or ovariohysterectomy (138) had been performed as a routine neutering procedure 8-11 years earlier. Complete data were available for 69 bitches of the ovariectomy group and for 66 bitches from the ovariohysterectomy group. There were no indications that endometritis had developed in bitches of the ovariectomy group. None of the bitches was sexually attractive to male dogs after neutering. The occurrence of a clear to white vaginal discharge was reported in two bitches of each group, but none of these four bitches appeared to be ill during the periods when the discharge was present. Furthermore, with the exception of urinary incontinence, no problems were reported that could be related to the surgical neutering. Six of the ovariectomized bitches and nine of the ovariohysterectomized bitches eventually developed urinary incontinence. Of these 15 bitches (11%), 12 weighed more than 20 kg. Bouvier des Flandres bitches were at a higher risk of developing urinary incontinence than were those of the other breeds. The possibility that the urinary incontinence was due at least in part to other conditions must be considered, since eight of the bitches were 9 years or older before urinary incontinence occurred and seven of the incontinent bitches also had polyuria or polydipsia. There were no significant differences in the incidence of urogenital problems listed above between the bitches of the ovariectomy and ovariohysterectomy group. It is hypothesized that a uterine disease such as CEH-endometritis cannot develop after complete ovariectomy, unless progestagens are administered. The results of this study indicate that ovariectomy does not increase the risk of CEH-endometritis or other complications in comparison with ovariohysterectomy. It is concluded that there is no indication for removing the uterus during routine neutering in healthy bitches. On the contrary, ovariectomy should be considered the procedure of choice.
虽然卵巢切除术比卵巢子宫切除术的侵入性小且耗时少，但大多数外科教科书仍推荐卵巢子宫切除术用于母犬的常规绝育。该建议可能基于对卵巢切除术后子宫疾病发生的担忧。然而，没有证据表明卵巢切除的母犬会发生诸如囊性子宫内膜增生（CEH）-子宫内膜炎等病症，除非给予孕激素。因此，本研究的目的是比较卵巢切除术和卵巢子宫切除术的长期影响，包括尿失禁的发生率。向264只母犬的主人发送了问卷，这些母犬在8至11年前接受了卵巢切除术（126只）或卵巢子宫切除术（138只）作为常规绝育程序。卵巢切除组的69只母犬和卵巢子宫切除组的66只母犬有完整的数据。没有迹象表明卵巢切除组的母犬发生了子宫内膜炎。绝育后，没有一只母犬对雄性犬有性吸引力。每组各有两只母犬报告有清亮至白色的阴道分泌物，但在出现分泌物的期间，这四只母犬均未表现出患病迹象。此外，除了尿失禁外，没有报告与手术绝育相关的问题。卵巢切除的母犬中有6只，卵巢子宫切除的母犬中有9只最终出现了尿失禁。在这15只母犬（11%）中，有12只体重超过20千克。法兰德斯畜牧犬比其他品种的母犬发生尿失禁的风险更高。必须考虑尿失禁至少部分归因于其他病症的可能性，因为其中8只母犬在发生尿失禁之前已9岁或以上，且7只失禁母犬也有多尿或多饮症状。卵巢切除组和卵巢子宫切除组的母犬在上述泌尿生殖问题的发生率上没有显著差异。据推测，除非给予孕激素，否则完全卵巢切除术后不会发生诸如CEH-子宫内膜炎等子宫疾病。本研究结果表明，与卵巢子宫切除术相比，卵巢切除术不会增加CEH-子宫内膜炎或其他并发症的风险。结论是，健康母犬在常规绝育时没有必要切除子宫。相反，应将卵巢切除术视为首选手术方法。
