Female urogenital surgery
Urine pooling, perineal body transection and urethral extension
Mares or cows with poor conformation, particularly splanchnoptosis, can develop urine pooling due to a tilt in the vaginal vault
Urine is highly irritating and can create further vaginitis and/or enter the uterus. Urine in the uterus causes fibrosis and leads to infertility.
Treatment
Since vaginitis can lead to urine pooling, the first treatment is typically a Caslicks. This is a bad idea if the vulva is severely tilted and mostly above the pelvic brim.
If problems persist, the perineal body can be transected (Pouret’s procedure), removing the traction from the viscera. This is a simple procedure performed with an epidural or line block. The tissue is transected until the vulva is again vertical. This is reflected internally as a flatter vaginal vault. While the article below describes closure, these usually do well when left to heal by second intention.
If perineal body transection is not sufficient, the urethra tunnel can be extended so that urine is released close to the vulvar lips, giving minimal opportunity to flow back toward the cervix. Both procedures can also be done at the same time.
Key Takeaways
To fix urine pooling:
- Perform Caslicks if slope isn’t too severe
- Perform perineal body transection if splanchnoptosis
- Perform urethral extension if still not fixed
Resources
Perineal body transection video- youtube
