Urinary bladder retroflexion and dystocia in a bitch with the vaginal supportive connective tissue failure
Abstract
This article describes a 2.5 years old cross breed bitch, weighing 35 kg, with dystocia and a large mass protruding through the vulva. A surgical resection of a type III vaginal prolapse had been performed 1.5 years previously. On admission, transabdominal ultrasonography revealed several live foetuses in the uterine horns, but the urinary bladder was not visible in the abdomen. An anechogenic, fluid-filled bladder was observed during ultrasonography of the protruded mass. Foetuses were removed by caesarean section. During the surgery, it was realized that the uterine body and a live foetus were confined within the vagina as well as the bladder. The foetus was removed by repositioning the corpus uteri and bladder gently, and ovariohysterectomy was performed. Although the situation is exceptional, urinary bladder retroflexion could occur due to the failure of supportive connective tissue of pelvic floor and extreme straining during parturition. Therefore, retroflexion should be managed as an emergency to reduce the pressure in the bladder and to rescue the foetus if it is in the protruded tissue into the vagina
Keywords
References
- 1. Arbeiter K, Bucher A (1994): Traumatically caused prolapse of the vaginal mucosa and retroflexion of the bladder in the bitch. Tierarztl Prax, 22, 78.
- 2. Arthur GH, Noakes DE, Pearson HA, et al. (1996): Maternal Dystocia: Treatment. In: Arthur GH, editor. Veterinary Reproduction and Obstetrics. 7th edn. WB Saunders Philadelphia, p: 203.
- 3. Barber JA (2003): Parturition and Dystocia. In: Root Kustritz MV, editor. Small Animal Theriogenology. Elsevier Sciences, Missouri, p: 255-257.
- 4. Bellenger CR (1980): Perineal hernia in dogs. Aust Vet J, 56, 434-438.
- 5. Bergstörm A, Nodtvedt A, Lagerstedt A, et al. (2006): Incidence and breed predilection for dystocia and risk factors for caesarean section in a Swedish population of insured dogs. Vet Surg, 35, 786-791.
- 6. Canatan HE, Ergin I, Polat IM, et al. (2015): Unusual cases of vaginal prolapse concurrent with cystocele in two dogs. Revue Med Vet, 166, 43-46.
- 7. Darvelid AW, Linde-Forsberg C (1994): Dystocia in the bitch: A retrospective study of 182 cases. J Small Anim Pract, 35, 402-407.
- 8. Ewies AA, Al-Azzawi F, Thompson J (2003): Changes in extracellular matrix proteins in the cardinal ligaments of postmenopausal women with or without prolapse: A computerized immunohistomorphometric analysis. Hum Reprod, 18, 2189-2195.
- 9. Jackson PGG (1972): Personal communication.
- 10. Jackson SR, Avery NC, Tarlton JF, et al. (1996): Changes in metabolism of collagen in genitourinary prolapse. Lancet, 347, 1658-1661.
- 11. Johnson CA (1986): Disorders of pregnancy. Vet Clin North Am Small Anim Pract, 16, 477-482.
- 12. Kabakaya GU, Salci H, Celimli N, et al. (2007): Retroflexion of the urinary bladder in a dog. Aust Vet Pract, 37, 50-52.
- 13. Kerkhof MH, Hendriks L, Brölmann HAM (2009): Changes in connective tissue in patients with pelvic organ prolapse-a review of the current literature. Int Urogynecol J, 20, 461-474.
- 14. Leveille R (1998): Ultrasonography of urinary bladder disorders. Vet Clin North Am Small Anim Pract, 31, 331.
- 15. Linde-Forsberg, C (2005): Abnormalities in pregnancy parturition, and the periparturient period, In: Ettinger SJ, Feldman E. Editors. C. Textbook of Veterinary Internal Medicine. Sixth edn. Philadelphia, PA, Saunders, p: 1655- 1667.
- 16. Liu X, Zhao Y, Pawlyk B, et al. (2006): Failure of elastic fiber homeostasis leads to pelvic floor disorders. Am J Pathol, 168, 519-528.
- 17. Mandel DC, Drobatz KJ (2000): Urinary bladder herniation through a vaginal tear in a rottweiller with dystocia. Vet Emerg Crit Care, 10, 173-175.
- 18. McClanahan SL, Malone ED, Anderson KL (2005): Bladder outlet obstruction in a 6-month-old alpaca secondary to pelvic displacement of the urinary bladder. Can Vet J, 46, 247.
- 19. McNamara PS, Harvey HJ, Dykes N (1997): Chronic vaginocervical prolapse with visceral incarceration in a dog. J Am Anim Hosp Assoc, 33, 533-536.
- 20. Moalli PA, Shand SH, Zyczynski HM, et al. (2005): Remodeling of vaginal connective tissue in patents with prolapse. Obstet Gynecol, 106, 953-963.
- 21. Mott JD, Werb Z (2004): Regulation of matrix biology by matrix metalloproteinases. Curr Opin Cell Biol, 16, 558- 564.
- 22. Niles JD, Williams JM (1999): Perineal hernia with bladder retroflexion in a female cocker spaniel. J Small Anim Pract, 40, 92-94.
- 23. Phillips CH, Anthony F, Benyon C, et al. (2006): Collagen metabolism in the uterosacral ligaments and vaginal skin of women with uterine prolapse. BJOG, 113, 39-46.
- 24. Risselada M, Kramer M, Van De Velde B, et al. (2003): Retroflexion of the urinary bladder associated with a perineal hernia in a female cat. J Small Anim Pract, 4, 508- 510.
- 25. Sontas BH, Apaydın SO, Toydemir TSF, et al. (2008): Perineal hernia because of retroflexion of the urinary bladder in a Rottweiler bitch during pregnancy. J Small Anim Pract, 49, 421-425.
- 26. Toniollo GH, Duarte JMB, Delfini A, et al. (2004): Bladder retroflexion. A case report in Blastocerus dichotomus (Cervo-do-Pantanal). Braz Vet Res Anim Sci, 41, 137-139.
- 27. White RAS, Herrtage ME (1986): Bladder retroflexion in the dog. J Small Anim Pract, 27, 735-746.
- 28. Zaks KL, Corti LB, Turner AI (2001): Veterinary medicine today: What’s your diagnosis? J Am Vet Med Assoc, 219, 21-22.
Bir köpekte vajinanın konnektif dokusunun yetersizliği ve güç doğum ile birlikte seyreden idrar kesesiretrofleksiyonu olgusu
Abstract
Bu olguda, 2,5 yaşında ve 35 kg ağırlığında melez ırk bir köpekte rastlanan güç doğum şikayeti ile birlikte vulvada büyük bir kitle olgusu sunuldu. Alınan anamnezde, 1,5 yıl önce köpeğe tip III prolapsus vagina nedeniyle submukozal rezeksiyon operasyonu uygulandığı öğrenildi. Kliniğimizde yapılan transabdominal ultrasonografik muayenede uterusta birkaç adet canlı fetüs saptanırken, idrar kesesi abdomen içinde gözlenemedi. Vulvadan dışarı çıkan kitleye yapılan ultrasonografi muayenesinde anekojenik yapıda, içi sıvı dolu idrar kesesi görüldü. Fetüsler sezaryen operasyonu ile alındı. Operasyon sırasında, korpus uteri ve bir adet canlı fetüs ile birlikte idrar kesesinin vagina duvarı içinde sınırlı olduğu saptandı. Korpus uteri ve idrar kesesi dikkatle abdominal boşluk içine alınarak fetüs çıkarıldı, ardından ovaryohisterektomi gerçekleştirildi. Bu olguya oldukça nadir rastlansa da, idrar kesesinin retrofleksiyonu pelvis tabanını destekleyen konnektif dokudaki yetersizliğe ve doğum sırasında aşırı ıkınmalara bağlı olarak şekillenebilmektedir. Bu nedenle, idrar kesesindeki basıncın azaltılması ve kitle içinde olabilecek fetüsün kurtarılabilmesi amacıyla olguya hızla müdahale edilmesi gerekmektedir
Keywords
References
- 1. Arbeiter K, Bucher A (1994): Traumatically caused prolapse of the vaginal mucosa and retroflexion of the bladder in the bitch. Tierarztl Prax, 22, 78.
- 2. Arthur GH, Noakes DE, Pearson HA, et al. (1996): Maternal Dystocia: Treatment. In: Arthur GH, editor. Veterinary Reproduction and Obstetrics. 7th edn. WB Saunders Philadelphia, p: 203.
- 3. Barber JA (2003): Parturition and Dystocia. In: Root Kustritz MV, editor. Small Animal Theriogenology. Elsevier Sciences, Missouri, p: 255-257.
- 4. Bellenger CR (1980): Perineal hernia in dogs. Aust Vet J, 56, 434-438.
- 5. Bergstörm A, Nodtvedt A, Lagerstedt A, et al. (2006): Incidence and breed predilection for dystocia and risk factors for caesarean section in a Swedish population of insured dogs. Vet Surg, 35, 786-791.
- 6. Canatan HE, Ergin I, Polat IM, et al. (2015): Unusual cases of vaginal prolapse concurrent with cystocele in two dogs. Revue Med Vet, 166, 43-46.
- 7. Darvelid AW, Linde-Forsberg C (1994): Dystocia in the bitch: A retrospective study of 182 cases. J Small Anim Pract, 35, 402-407.
- 8. Ewies AA, Al-Azzawi F, Thompson J (2003): Changes in extracellular matrix proteins in the cardinal ligaments of postmenopausal women with or without prolapse: A computerized immunohistomorphometric analysis. Hum Reprod, 18, 2189-2195.
- 9. Jackson PGG (1972): Personal communication.
- 10. Jackson SR, Avery NC, Tarlton JF, et al. (1996): Changes in metabolism of collagen in genitourinary prolapse. Lancet, 347, 1658-1661.
- 11. Johnson CA (1986): Disorders of pregnancy. Vet Clin North Am Small Anim Pract, 16, 477-482.
- 12. Kabakaya GU, Salci H, Celimli N, et al. (2007): Retroflexion of the urinary bladder in a dog. Aust Vet Pract, 37, 50-52.
- 13. Kerkhof MH, Hendriks L, Brölmann HAM (2009): Changes in connective tissue in patients with pelvic organ prolapse-a review of the current literature. Int Urogynecol J, 20, 461-474.
- 14. Leveille R (1998): Ultrasonography of urinary bladder disorders. Vet Clin North Am Small Anim Pract, 31, 331.
- 15. Linde-Forsberg, C (2005): Abnormalities in pregnancy parturition, and the periparturient period, In: Ettinger SJ, Feldman E. Editors. C. Textbook of Veterinary Internal Medicine. Sixth edn. Philadelphia, PA, Saunders, p: 1655- 1667.
- 16. Liu X, Zhao Y, Pawlyk B, et al. (2006): Failure of elastic fiber homeostasis leads to pelvic floor disorders. Am J Pathol, 168, 519-528.
- 17. Mandel DC, Drobatz KJ (2000): Urinary bladder herniation through a vaginal tear in a rottweiller with dystocia. Vet Emerg Crit Care, 10, 173-175.
- 18. McClanahan SL, Malone ED, Anderson KL (2005): Bladder outlet obstruction in a 6-month-old alpaca secondary to pelvic displacement of the urinary bladder. Can Vet J, 46, 247.
- 19. McNamara PS, Harvey HJ, Dykes N (1997): Chronic vaginocervical prolapse with visceral incarceration in a dog. J Am Anim Hosp Assoc, 33, 533-536.
- 20. Moalli PA, Shand SH, Zyczynski HM, et al. (2005): Remodeling of vaginal connective tissue in patents with prolapse. Obstet Gynecol, 106, 953-963.
- 21. Mott JD, Werb Z (2004): Regulation of matrix biology by matrix metalloproteinases. Curr Opin Cell Biol, 16, 558- 564.
- 22. Niles JD, Williams JM (1999): Perineal hernia with bladder retroflexion in a female cocker spaniel. J Small Anim Pract, 40, 92-94.
- 23. Phillips CH, Anthony F, Benyon C, et al. (2006): Collagen metabolism in the uterosacral ligaments and vaginal skin of women with uterine prolapse. BJOG, 113, 39-46.
- 24. Risselada M, Kramer M, Van De Velde B, et al. (2003): Retroflexion of the urinary bladder associated with a perineal hernia in a female cat. J Small Anim Pract, 4, 508- 510.
- 25. Sontas BH, Apaydın SO, Toydemir TSF, et al. (2008): Perineal hernia because of retroflexion of the urinary bladder in a Rottweiler bitch during pregnancy. J Small Anim Pract, 49, 421-425.
- 26. Toniollo GH, Duarte JMB, Delfini A, et al. (2004): Bladder retroflexion. A case report in Blastocerus dichotomus (Cervo-do-Pantanal). Braz Vet Res Anim Sci, 41, 137-139.
- 27. White RAS, Herrtage ME (1986): Bladder retroflexion in the dog. J Small Anim Pract, 27, 735-746.
- 28. Zaks KL, Corti LB, Turner AI (2001): Veterinary medicine today: What’s your diagnosis? J Am Vet Med Assoc, 219, 21-22.
Details
| Primary Language | English |
|---|---|
| Subjects | Veterinary Surgery |
| Other ID | JA23BA37RC |
| Journal Section | Short Report |
| Authors | |
| Publication Date | March 1, 2017 |
| Published in Issue | Year 2017 |