Female urogenital surgery

How to – Perineal body transection

Indications

Perineal body transection is performed for severe splanchnoptosis and for mild cases of urine pooling.

Relevant anatomy

The perineal body is located between the dorsal vagina and the rectal floor. It is comprised of sphincter muscles that create tone for the vestibule, help maintain the vestibular sphincter, and also connects the vaginal vault to the rectum and viscera (this isn’t always helpful).

 

Preoperative management

Food restrictions: NA

NSAIDs/analgesics: Preoperative NSAID recommended

Antibiotics: NA

Tetanus prophylaxis is recommended. 

Local blocks: Line block or epidural

Position/preparation: Standing procedure. The rectum should be emptied prior to surgery. The area is cleaned and blocked. Surgeon should be gloved.

Surgery Supplies: 

  • Scalpel blade and handle
  • Towel clamps

Surgical procedure

A towel clamp is hung on the dorsal aspect of the vulva. A 4-6 cm inverted U incision is made between the rectum and vagina. Sharp scalpel dissection is carried forward until the vulva is vertical. Slight additional dissection may be helpful to minimize the effect of scar tissue formation during healing.

The towel clamp is removed and the area left open for second intention healing.

Postoperative care

  • Clean the wound daily until epithelialized.

Complications

  • Very extensive dissection could enter the peritoneal cavity but this would be difficult as the peritoneal reflection is approximately 12″ deep

Videos

Perineal body transection

Resources

 

License

Icon for the Creative Commons Attribution-NonCommercial 4.0 International License

Large Animal Surgery - Supplemental Notes by Erin Malone, DVM, PhD; Elaine Norton, DVM PhD; Erica Dobbs, DVM; and Ashley Ezzo, DVM is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, except where otherwise noted.