Surgical Repair of the Traumatic Urethral Transection with Urethrocutaneous Fistula in a Pung-san Dog

풍산 개에서 발생한 외상성 요도 절단과 요도 피부 누공의 수술적 교정

  • Lee, Jae-Hoon (Department of Veterinary Surgery, College of Veterinary Medicine, Konkuk University) ;
  • Kim, Song-Ho (Department of Veterinary Surgery, College of Veterinary Medicine, Konkuk University) ;
  • Yang, Wo-Jong (Department of Veterinary Surgery, College of Veterinary Medicine, Konkuk University) ;
  • Kang, Eun-Hee (Department of Veterinary Surgery, College of Veterinary Medicine, Konkuk University) ;
  • Chang, Hwa-Seok (Department of Veterinary Surgery, College of Veterinary Medicine, Konkuk University) ;
  • Chung, Dai-Jung (Department of Veterinary Surgery, College of Veterinary Medicine, Konkuk University) ;
  • Kim, Hwi-Yool (Department of Veterinary Surgery, College of Veterinary Medicine, Konkuk University)
  • Accepted : 2010.05.26
  • Published : 2010.06.30

Abstract

A five-year-old, castrated male, Pung-san dog was referred to Konkuk University Veterinary Teaching Hospital with trauma and persistent hemorrhage in the inguinal region. The dog had a history of being wounded by a wild boar at 5 days prior to presentation. Rupture of the membranous urethra and urethrocutaneous fistula were demonstrated by the retrograde positive contrast urethrography. A urinary catheter was placed to identify the urethra and urethrocutaneous fistula. The necrotic tissues and damaged tissues by urine leakage around urethrocutaneous fistula were debrided. An urethral anastomosis over an indwelling catheter was performed. The dog maintained normal urination without other complications including dysuria and hematouria at the follow-up evaluation after 1 month postoperatively. A retrograde urethrogram repeated at 2 months after surgery showed no urethral stricture.

5살의 중성화된 수컷 풍산 개가 서혜부에 지속적인 출혈 증상으로 내원하였다. 내원 5일 전에 멧돼지에게 공격을 받은 병력을 가지고 있었으며, 양성 요도 조영술에서 막성 요도의 파열과 요도 피부 누공이 있음을 확인 하였다. 수술 중 요도 카테터를 장착하여서 요도와 요도 피부 누공을 확인 하였고, 오줌의 누출로 인해 발생한 괴사 조직과 손상된 조직을 제거 하였다. 요도 카테터를 장착하여 요도 문합술을 실시하였다. 술 후 한달 째 배뇨장애나 혈뇨 증상이 없이, 정상적인 배뇨를 유지하였으며, 수술 후 2 달째 실시한 역행성 양성 요도 조영술에서 요도 협착 소견을 보이지 않았다.

Keywords

References

  1. Anderson RB, Aronson LR, Drobatz KJ, Atilla A. Prognostic factors for successful outcome following urethral rupture in dogs and cats. J Am Anim Hosp Assoc 2006; 42: 136-146. https://doi.org/10.5326/0420136
  2. Anson LW. Urethral trauma and principles of urethral surgery. Compend Contin Educ Pract Vet 1987; 9: 981-988.
  3. Bjorling DE, The urethra. In: Slatter D: Textbook of small animal surgery, 3rd ed. Philadelphia, Saunders. 2003: 1638- 1651.
  4. Chapple C, Barbagli G, Jordan G., Mundy AR, Rodriguesnetto N, Pansadoros V. McAninch JW. Consensus on genitourinary trauma. BJU International 2004; 93: 1195-1202. https://doi.org/10.1111/j.1464-410x.2004.04805.x
  5. Cooley AJ, Waldron DR, Smith MM, Saunders GK, Troy GC, Barber DL. The effects of indwelling transurethral catheterization and tube cystostomy on urethral anastomoses in dogs. J Am Anim Hosp Assoc 1999; 35: 341-347. https://doi.org/10.5326/15473317-35-4-341
  6. Fossum TW. Surgery of the bladder and urethra. In: Small animal surgery, 3rd ed. Mosby. 2007: 663-701.
  7. Hay CW, Rosin E. Repair of an intrapelvic urethral tear in a bitch caused by iatrogenic trauma. Vet Rec 1997; 140: 48-49. https://doi.org/10.1136/vr.140.2.48
  8. Holt PE. Hindlimb skin loss associated with urethral rupture in two cats. J Small Anim Pract 1989; 30: 406-409. https://doi.org/10.1111/j.1748-5827.1989.tb01591.x
  9. Kleine LJ, Thornton GW. Radiographic diagnosis of urinary tract trauma. J Am Anim Hosp Assoc 1971; 7: 318-327.
  10. Kolata RJ, Johnston DE. Motor vehicle accidents in urban dogs: A study of 600 cases. J Am Vet Med Assoc. 1975; 167: 938-941.
  11. Layton CE, Ferguson HR, Cook JE, Guffy MM. Intrapelvic urethral anastomosis. A comparison of three techniques. Vet Surg 1987; 16: 175-182 https://doi.org/10.1111/j.1532-950X.1987.tb00933.x
  12. McRoberts JW, Ragde H. The severed canine posterior urethra: a study of two distinct methods of repair. J Urol 1970; 104: 724-729 https://doi.org/10.1016/S0022-5347(17)61821-4
  13. Mitchell JP. Injuries to the urethra. Br J Urol 1968; 40: 649- 670.
  14. Selcer BA. Urinary tract trauma associated with pelvic trauma. J Am Anim Hosp Assoc 1982; 18: 785-793.