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
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
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
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.
There are 28 citations in total.
Details
Primary Language
English
Subjects
Veterinary Surgery
Other ID
JA23BA37RC
Journal Section
Short Report
Authors
Duygu Baki Acar
Muhammed Kürşad Birdane
Afyon Kocatepe University, Faculty of Veterinary Medicine, Department of Obstetrics and Gynaecology, Afyonkarahisar, Turkey.
Baki Acar, D., & Birdane, M. K. (2017). Urinary bladder retroflexion and dystocia in a bitch with the vaginal supportive connective tissue failure. Ankara Üniversitesi Veteriner Fakültesi Dergisi, 64(1), 61-64. https://doi.org/10.1501/Vetfak_0000002775
AMA
Baki Acar D, Birdane MK. Urinary bladder retroflexion and dystocia in a bitch with the vaginal supportive connective tissue failure. Ankara Univ Vet Fak Derg. March 2017;64(1):61-64. doi:10.1501/Vetfak_0000002775
Chicago
Baki Acar, Duygu, and Muhammed Kürşad Birdane. “Urinary Bladder Retroflexion and Dystocia in a Bitch With the Vaginal Supportive Connective Tissue Failure”. Ankara Üniversitesi Veteriner Fakültesi Dergisi 64, no. 1 (March 2017): 61-64. https://doi.org/10.1501/Vetfak_0000002775.
EndNote
Baki Acar D, Birdane MK (March 1, 2017) Urinary bladder retroflexion and dystocia in a bitch with the vaginal supportive connective tissue failure. Ankara Üniversitesi Veteriner Fakültesi Dergisi 64 1 61–64.
IEEE
D. Baki Acar and M. K. Birdane, “Urinary bladder retroflexion and dystocia in a bitch with the vaginal supportive connective tissue failure”, Ankara Univ Vet Fak Derg, vol. 64, no. 1, pp. 61–64, 2017, doi: 10.1501/Vetfak_0000002775.
ISNAD
Baki Acar, Duygu - Birdane, Muhammed Kürşad. “Urinary Bladder Retroflexion and Dystocia in a Bitch With the Vaginal Supportive Connective Tissue Failure”. Ankara Üniversitesi Veteriner Fakültesi Dergisi 64/1 (March 2017), 61-64. https://doi.org/10.1501/Vetfak_0000002775.
JAMA
Baki Acar D, Birdane MK. Urinary bladder retroflexion and dystocia in a bitch with the vaginal supportive connective tissue failure. Ankara Univ Vet Fak Derg. 2017;64:61–64.
MLA
Baki Acar, Duygu and Muhammed Kürşad Birdane. “Urinary Bladder Retroflexion and Dystocia in a Bitch With the Vaginal Supportive Connective Tissue Failure”. Ankara Üniversitesi Veteriner Fakültesi Dergisi, vol. 64, no. 1, 2017, pp. 61-64, doi:10.1501/Vetfak_0000002775.
Vancouver
Baki Acar D, Birdane MK. Urinary bladder retroflexion and dystocia in a bitch with the vaginal supportive connective tissue failure. Ankara Univ Vet Fak Derg. 2017;64(1):61-4.