Ventrocaudal cystorrhaphy without urethral sphincterotomy in two broodmares

Abstract

Summary Two broodmares were diagnosed with rupture of the urinary bladder. One mare revealed abnormalities post partum and the other associated with ante partum uterine torsion. The clinical symptoms included mild abdominal pain, anorexia, decreased urinary volume and increased peritoneal fluid. In one mare, based on the creatinine level of the peritoneal fluid and serum biochemical abnormalities, uroperitoneum was diagnosed. In the other mare, the bladder rupture was found during the celiotomy for surgical repair of uterine torsion that was diagnosed upon rectal examination. Surgery was performed without a urethral sphincterotomy. The vaginal floor was incised in a standing position and the bladder was diverted into the vagina in order to suture the tears located in the ventrocaudal aspect of the bladder. Both mares survived after treatment for uraemia. Bladder rupture, although uncommon, may affect peripartum mares. Approach to the ruptured bladder without urethral sphincterotomy in a standing position should be considered as a choice for surgical repair.

Conservative management of cystorrhexis in four adult horses

“…Adequate exteriorisation may sometimes even be impossible, particularly if the location of the tear is near the neck of the bladder (Higuchi et al . ). Additionally, general anaesthesia carries inherent risks, particularly in the periparturient broodmare.…”

“…; Higuchi et al . ). Standing surgical repair techniques have been associated with post operative complications, including urine pooling and dribbling after urethral sphincterotomy (White ) and complications with wound healing after incising and suturing damaged vaginal mucosa in post parturient mares (Rodgerson et al .…”

“…To date, most reported treatments of traumatic cystorrhexis in adult horses have involved some form of surgical repair of the bladder wall defect (White 1977;Rodgerson et al 1999;Higuchi et al 2002Higuchi et al , 2012Rijkenhuizen et al 2008;Stephen et al 2009;Tuohy et al 2009). However, exteriorisation and surgical repair of the bladder in adult horses through a ventral celiotomy can be difficult due to its intrapelvic location and depth of the equine abdomen (Gibson et al 1992;Rodgerson et al 1999;Schott and Woodie 2012).…”

“…However, exteriorisation and surgical repair of the bladder in adult horses through a ventral celiotomy can be difficult due to its intrapelvic location and depth of the equine abdomen (Gibson et al 1992;Rodgerson et al 1999;Schott and Woodie 2012). Adequate exteriorisation may sometimes even be impossible, particularly if the location of the tear is near the neck of the bladder (Higuchi et al 2012). Additionally, general anaesthesia carries inherent risks, particularly in the periparturient broodmare.…”

Bladder rupture in the mature horse: Diagnostic techniques

“…In the healthy individual the bladder is readily distended with gas and the ureteral openings may be identified. As the authors of the preceding case series reported (Higuchi et al 2012), it is often difficult to achieve distention of the bladder in horses with a bladder rupture. If the bladder does not readily distend upon insufflation, a rupture should be suspected and excessive gas should not be introduced.…”