Vaginal resection and anastomosis for treatment of vestibulovaginal stenosis in 4 dogs with recurrent urinary tract infections

Abstract

CASE DESCRIPTION-4 dogs were evaluated because of recurrent urinary tract infections. CLINICAL FINDINGS-All dogs had recurrent urinary tract infections and similar clinical signs; 3 dogs had urinary incontinence. Digital vaginal examination revealed vestibulovaginal stenosis in all dogs, which was confirmed by results of contrast vaginourethrography. From image measurements, the vestibulovaginal ratio (ratio of the height of the vestibulovaginal junction to the maximum height of the vagina on a lateral vaginourethrogram) was calculated for each dog. Three dogs had severe stenosis (vestibulovaginal ratio, < 0.20; severe stenosis is defined as a vestibulovaginal ratio < 0.20), whereas the fourth dog had moderate stenosis (vestibulovaginal ratio, 0.24; ratio range for moderate stenosis is 0.20 to 0.25). TREATMENT AND OUTCOME-All dogs were anesthetized for surgical correction of the vestibulovaginal stenosis. Vaginal resection and anastomosis of the stenosis was performed in all 4 dogs, with 1 dog also undergoing episioplasty. Complete resolution of clinical signs was apparent in 3 dogs; 1 dog had postoperative complications including pollakiuria and stranguria, which resulted in rectal and vaginal prolapse. This dog underwent ovariohysterectomy, after which clinical signs resolved. All dogs had resolution of urinary tract infections at the time of follow-up (6 to 8 months after surgery). CLINICAL RELEVANCE-Resection and anastomosis may resolve recurrent urinary tract infections in dogs with severe or moderate vestibulovaginal stenosis. Episiotomy was not necessary for success of surgical treatment, and overall, that procedure increased morbidity, the severity of intraoperative hemorrhage, and duration of surgery.

Endoscopic-guided laser ablation of vestibulovaginal septal remnants in dogs: 36 cases (2007–2011)

“…These may be an incidental finding in some dogs, whereas others may develop a variety of signs, including difficulty during natural breeding, persistent urinary incontinence, vaginal pooling of urine, chronic recurrent UTIs, dysuria, infertility, recurrent SMALL ANIMALS/ EXOTIC vaginitis, dystocia, vulvar dermatitis, and ambiguous external genitalia. [1][2][3][4][5]7,8 These anomalies have no reported genetic or breed predisposition. 1,4 The overall prevalence of these malformations is also unknown, given that most dogs are spayed early in life, are never bred, and may never have clinical signs warranting further investigation.…”

Management of a postoperative vaginal stricture by perendoscopic balloon dilation in a dog

“…Vestibulovaginal stenotic lesions are developmental anomalies that are the result of retained epithelial tissue at the point of fusion of the paired paramesonephric ducts in the sagittal plane (a vaginal septum) or at the transverse junction of the paramesonephric ducts with the urogenital sinus (an imperforate hymen) in the area of the vestibulovaginal junction (Adin 2012). Described treatments include manual dilation of the stenosis, T‐shaped vaginoplasty, vaginectomy, resection of the stenotic area (Kyles and others 1996) and vaginal resection and anastomosis (Kieves and others 2011). Fibrosis and stricture formation are observed in tubular soft tissue after trauma or disease.…”

Computed tomography can differentiate vaginal-origin from uterine-origin lesions in bitches

“…The ratio of the vestibulovaginal junction width to the maximal vaginal width was 0.2, indicating that vestibulovaginal stenosis was present (vestibulovaginal ratio: < 0.20, severe; 0.20 to 0.25, moderate; 0.26 to 0.35, mild). 5,10 Hematocolpos secondary to vestibulovaginal stenosis was diagnosed based on CT and fluid sample findings. A digital vaginal examination revealed a narrowed lumen of the vestibulovaginal junction (cingulum septum), with complete obstruction between the vagina and vestibule.…”

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I n sexually intact female dogs with a caudal abdominal mass, determining the origin of lesions between the uterus and vagina is important for diagnosis and treatment plans. [1][2][3][4][5] Hydrometra, mucometra, hemometra, and pyometra with or without cystic endometrial hyperplasia are generally suspected when a fluid-filled tubular or cystic structure that originates from the uterus is present. 6,7 In the vagina, the tumors of muscle or fibrous tissue origin (leiomyoma, fibroma, and leiomyosarcoma) are most commonly found.

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“…osteotomy, episiotomy, and perineal urethrostomy may be required during vaginal tumor resection. [2][3][4][5] Ultrasonography is the first step in the diagnosis of reproductive tract lesions. However, the visibility of the intrapelvic portion of the vagina is limited with ultrasonography, even when combining perineal and dorsal approaches.…”