Intrapelvic Urethral Anastomosis in a Dog with Complete Obstruction of Proximal Membranous Urethra

막성요도 근위부 완전폐쇄를 지닌 개에서 골반내 요도문합술

  • Yoon Hun-Young (Department of Veterinary Surgery College of Veterinary Medicine, Konkuk University) ;
  • Kim Jun-Young (Department of Veterinary Surgery College of Veterinary Medicine, Konkuk University) ;
  • Han Hyun-Jung (Department of Veterinary Surgery College of Veterinary Medicine, Konkuk University) ;
  • Jang Ha-Young (Department of Veterinary Surgery College of Veterinary Medicine, Konkuk University) ;
  • Lee Bo-Ra (Department of Veterinary Surgery College of Veterinary Medicine, Konkuk University) ;
  • NamKung Hyo-Sun (Department of Veterinary Surgery College of Veterinary Medicine, Konkuk University) ;
  • Jeong Soon-Wuk (Department of Veterinary Surgery College of Veterinary Medicine, Konkuk University)
  • 윤헌영 (건국대학교 수의과대학 수의외과학교실) ;
  • 김준영 (건국대학교 수의과대학 수의외과학교실) ;
  • 한현정 (건국대학교 수의과대학 수의외과학교실) ;
  • 장하영 (건국대학교 수의과대학 수의외과학교실) ;
  • 이보라 (건국대학교 수의과대학 수의외과학교실) ;
  • 남궁효선 (건국대학교 수의과대학 수의외과학교실) ;
  • 정순욱 (건국대학교 수의과대학 수의외과학교실)
  • Published : 2006.03.01

Abstract

A 4.65 kg 13-month-old male Pekingese dog was referred to veterinary teaching hospital of Konkuk University for evaluation of dysuria. On physical examination, severe distention of urinary bladder was found in abdominal palpation. Urinary catheter could not be guided into urinary bladder. On serum biochemistry, blood urea nitrogen (35.6 mg/dl) and creatinine (1.9 mg/dl) were increased. Obstruction part of proximal membranous urethra was founded on urethrogram. The length (13 mm) of obstruction part was callipered by cystourethrogram and urethrogram on operation. Surgical resection of obstruction part of urethra was performed without pubic osteotomy, and anastomosis was performed with 5-0 polyglycolic acid. Omentum was placed around the urethral anastomosis. On first day after surgery, appetite was good. On day 5, complete blood count and serum biochemistry showed normal range but mild urinary incontinence was showed after removing catheter. On day 7, urinalysis showed normal condition. On day 14, no leakage of surgical site was observed in excretory urogram. On day 21, no more urinary incontinence and good micturition were found. On 1 year later, the patient showed healthy condition without recurrence.

체중 4.65kg, 나이 13 개월의 수컷 페키니즈 견이 무뇨 증상으로 건국대학교 수의과대학 부속 동물병원에 내원하였다. 신체 검사상에서 복부 촉진을 통해 심각한 방광 팽창을 확인 하였다. 방광 내 요도 카테터 삽입을 시도 하였으나 실패 하였다. 혈액 화학 검사에서 BUN농도(35.6mg/dl)와 크레아틴농도(1.9mg/dl)가 각각 상승된 것으로 나타났다.단순 방사선 및 요도조영술에서 심한 방광팽창 및 막성 요도의 시작 부분이 폐쇄된 소견을 보였다. 수술동안 투시기를 이용 방광요도조영술과 요도조영술을 동시에 실시하여 본 바 폐쇄 부분 길이가 13mm임을 확인하였다. 골반강내 위치한 요도 폐쇄 부위가 피부절개선상까지 견인으로 노출이 가능하여 치골절골술 없이도 요도절제 및 요도문합을 실시할 수 있었다. 요도를 5-0 polyglycolic acid로 문합하고 이 부위를 대망막으로 감쌌다. 수술 후 첫째 날, 식욕이 회복 되었고, 5일 째 비정상 범위를 보였던 혈청 화학 수치들이 정상을 보였다. 그러나 요도 카테터를 제거한 후 약간의 요실금이 관찰 되었다. 7일 째 뇨 분석 결과가 정상 수치를 나타냈고, 14일 째 배설성 요로 조영술을 통해 수술 부위에 소변 누수가 없음을 확인 하였다. 21일 째, 더 이상의 요실금이 확인 되지 않았으며, 1년이 지난 현재 재발없이 정상적인 배뇨와 건강한 상태임을 확인할 수 있었다.

Keywords

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