Radical prostatectomy with Van Velthoven Suture to canine perineal / Prostatectomia radical com sutura de Van Velthoven na herniorrafia perineal de canino

Background: Prostatectomy excision is indicated for patients with neoplasm, trauma or recurrent prostatic abscess; Van Velthoven suture have been used in urethrovesical laparoscopic anastomosis in humans. This report aimed to describe the use of Van Velthoven suture after excisional prostatectomy in a canine, which suffered partial loss and deformation of the urinary bladder after complications of perineal hernia.Case: A thirteen-year-old male dog presented dyschezia, hypophagia and had increased water ingestion; furthermore, owner verifi ed a swelling lateral to the anus. On clinical examination it was observed left perineal hernia with incarcerated content, and peritonitis was diagnosed by ultrasonography exam. Antimicrobial and fl uid therapy were initiated, and one day after the patient was referred to surgery. Through perineal access was observed retrofl exed urinary bladder partially necrotic and multiple prostatic cysts; due to great extent of the necrotic urinary bladder, associated with impossibility of complete necrotic bladder tissue removal, prostate and urinary vesicle were placed in the peritoneal cavity. It was proceeded hernia reconstruction using polypropylene mesh and monofi lament nylon suture. Through median celiotomy, the bladder necrotic tissue was removed; due to hemodynamic patient instability, the total prostatectomy that was initiated was postponed, pe

Background: Prostatectomy excision is indicated for patients with neoplasm, trauma or recurrent prostatic abscess; Van Velthoven suture have been used in urethrovesical laparoscopic anastomosis in humans. This report aimed to describe the use of Van Velthoven suture after excisional prostatectomy in a canine, which suffered partial loss and deformation of the urinary bladder after complications of perineal hernia.Case: A thirteen-year-old male dog presented dyschezia, hypophagia and had increased water ingestion; furthermore, owner verifi ed a swelling lateral to the anus. On clinical examination it was observed left perineal hernia with incarcerated content, and peritonitis was diagnosed by ultrasonography exam. Antimicrobial and fl uid therapy were initiated, and one day after the patient was referred to surgery. Through perineal access was observed retrofl exed urinary bladder partially necrotic and multiple prostatic cysts; due to great extent of the necrotic urinary bladder, associated with impossibility of complete necrotic bladder tissue removal, prostate and urinary vesicle were placed in the peritoneal cavity. It was proceeded hernia reconstruction using polypropylene mesh and monofi lament nylon suture. Through median celiotomy, the bladder necrotic tissue was removed; due to hemodynamic patient instability, the total prostatectomy that was initiated was postponed, pe

Prostatectomia radical com sutura de Van Velthoven na herniorrafia perineal de canino / Radical Prostatectomy with Van Velthoven Suture to Canine Perineal Herniorrhaphy

Background: Prostatectomy excision is indicated for patients with neoplasm, trauma or recurrent prostatic abscess; Van Velthoven suture have been used in urethrovesical laparoscopic anastomosis in humans. This report aimed to describe the use of Van Velthoven suture after excisional prostatectomy in a canine, which suffered partial loss and deformation of the urinary bladder after complications of perineal hernia. Case: A thirteen-year-old male dog presented dyschezia, hypophagia and had increased water ingestion; furthermore, owner verified a swelling lateral to the anus. On clinical examination it was observed left perineal hernia with incarcerated content, and peritonitis was diagnosed by ultrasonography exam. Antimicrobial and fluid therapy were initiated, and one day after the patient was referred to surgery. Through perineal access was observed retrofl exed urinary bladder partially necrotic and multiple prostatic cysts; due to great extent of the necrotic urinary bladder, associated with impossibility of complete necrotic bladder tissue removal, prostate and urinary vesicle were placed in the peritoneal cavity. It was proceeded hernia reconstruction using polypropylene mesh and monofilament nylon suture. Through median celiotomy, the bladder necrotic tissue was removed; due to hemodynamic patient instability, the total prostatectomy that was initiated was postponed, performing cystopexy and cystostomy with Foley catheter. The prostatectomy was performed at the 21st day. In that time, prostatic urethra stenosis was observed. After probing urethral repair points in the pelvic urethra and urinary bladder, the prostate was resected and was applied a Van Velthoven suture. Omentalization of the anastomotic site was done before cavity washing with NaCl 0,9%. The abdominal access was closed in three layers. The patient remained probed for six days, and after this bladder compression was initiated. After 21 days of the second operative intervention, it was necessary to correct a perineal hernia in the opposite side; reconstruction was performed by mobilizing obturator internus muscle. Discussion: In many cases of perineal herniation it was observed prostatic hypertrophy and cysts, as observed in our clinical case. After castration, prostate involutes in two or three weeks, and occur clinical signs reliefs. But the patient related shows presence of urethral stricture, helding an excisional prostatectomy. After excision of the prostate, special attention should be given to the anastomosis between urinary bladder and urethra. With the circular Van Velthoven suture was observed low incidence of bladder contraction in humans, condition which could lead to, among other things, urinary incontinence. It was observed easy and speed of execution of the technique as well as obtaining an anastomosis without tension and adequate to anastomosis healing, as well appropriated patient recovery. We concluded that Van Velthoven suture is effective to prostatectomy in dogs and that the perineal hernia may be associated with several complications that could be adequately treated by surgery.

Prostatectomia radical pelo acesso perineal associado à cistostomia com sonda e orquiectomia no tratamento de hérnia perineal em cão - Relato de caso / Radical protatectomy through perineal access associated with sounding cystostomy and orchiectomy for treatment of perineal hernia in a dog - Case report

Dentre as diferentes técnicas para a realização de prostatectomia radical, a obtida pelo acesso perinealé utilizada por mais de um século na medicina humana. Porém, esse acesso não é comumente utilizadoem cães com hérnia perineal. Esse relato apresenta um caso de prostatectomia radical perineal emcão com diagnóstico de hérnia perineal unilateral envolvendo vesícula urinária e próstata. A operaçãofoi realizada através de incisão sobre o aumento do volume, a partir da qual se realizou dissecçãode aderências, ligadura de vasos prostáticos e ressecção e anastomose vesicouretral com fi o de poliglactina910. A vesícula urinária foi reposicionadae a herniorrafi a obtida com tela de polipropileno.Procedeu-setambém cistostomia e orquiectomia. Não houve sinais de recidiva ou complicações doismeses após o procedimento, demonstrando a viabilidade da prostatectomia total via hérnia perinealem cães(AU)

Among all techniques for radical prostatectomy, the perineal access itsthe most common in medicine.However, this technique is not common for perineal hernia treatment in dogs. This case reportpresents a perineal prostatectomy in a dog with unilateral perineal hernia containing bladder andprostate. The procedure was made by an incision over the hernia, dissecting adherences, hemostasyof prostatic vessels, resection and vesicourethral anastomosis with poliglactine 910. The bladder wasrepositioned and the herniorraphy was made by polypropylene mesh application.Cystostomy followedby orchiectomy was made for vesical outfl ow maintenance. No signs of complications happenedafter two months of the procedure, showing that radical prostatectomy is viable by perineal hernia indogs(AU)

Prostatectomia radical pelo acesso perineal associado à cistostomia com sonda e orquiectomia no tratamento de hérnia perineal em cão - Relato de caso / Radical protatectomy through perineal access associated with sounding cystostomy and orchiectomy for treatment of perineal hernia in a dog - Case report

Dentre as diferentes técnicas para a realização de prostatectomia radical, a obtida pelo acesso perinealé utilizada por mais de um século na medicina humana. Porém, esse acesso não é comumente utilizadoem cães com hérnia perineal. Esse relato apresenta um caso de prostatectomia radical perineal emcão com diagnóstico de hérnia perineal unilateral envolvendo vesícula urinária e próstata. A operaçãofoi realizada através de incisão sobre o aumento do volume, a partir da qual se realizou dissecçãode aderências, ligadura de vasos prostáticos e ressecção e anastomose vesicouretral com fi o de poliglactina910. A vesícula urinária foi reposicionadae a herniorrafi a obtida com tela de polipropileno.Procedeu-setambém cistostomia e orquiectomia. Não houve sinais de recidiva ou complicações doismeses após o procedimento, demonstrando a viabilidade da prostatectomia total via hérnia perinealem cães

Among all techniques for radical prostatectomy, the perineal access it’sthe most common in medicine.However, this technique is not common for perineal hernia treatment in dogs. This case reportpresents a perineal prostatectomy in a dog with unilateral perineal hernia containing bladder andprostate. The procedure was made by an incision over the hernia, dissecting adherences, hemostasyof prostatic vessels, resection and vesicourethral anastomosis with poliglactine 910. The bladder wasrepositioned and the herniorraphy was made by polypropylene mesh application.Cystostomy followedby orchiectomy was made for vesical outfl ow maintenance. No signs of complications happenedafter two months of the procedure, showing that radical prostatectomy is viable by perineal hernia indogs

REIMPLANTAÇÃO DE URETER ECTÓPICO EM CADELA

SUMMARY A case of an ectopic left ureter in a bitch is reported. The clinical symptoms, radiological and surgical diagnostic, ureterovesical anastomosis with ureter reimplantation at the vesical trigon and post surgical evaluation through an excretory urography objecting to demonstrate the ureteral function are described.

RESUMO Relata-se um caso de ectopia uretral esquerda em cadela. Descreve-se os sintomas, diagnóstico radiológico e cirúrgico, anastomose vesicouretral com reimplante do ureter no trígono vesical e exame radiográfico pós-operatório através de urografia excretora para avaliação da função renal e ureteral.

Reimplantação de ureter ectópico em cadela

SUMMARY A case of an ectopic left ureter in a bitch is reported. The clinical symptoms, radiological and surgical diagnostic, ureterovesical anastomosis with ureter reimplantation at the vesical trigon and post surgical evaluation through an excretory urography objecting to demonstrate the ureteral function are described.

RESUMO Relata-se um caso de ectopia uretral esquerda em cadela. Descreve-se os sintomas, diagnóstico radiológico e cirúrgico, anastomose vesicouretral com reimplante do ureter no trígono vesical e exame radiográfico pós-operatório através de urografia excretora para avaliação da função renal e ureteral.

Radical prostatectomy with Van Velthoven Suture to canine perineal / Prostatectomia radical com sutura de Van Velthoven na herniorrafia perineal de canino

Background: Prostatectomy excision is indicated for patients with neoplasm, trauma or recurrent prostatic abscess; Van Velthoven suture have been used in urethrovesical laparoscopic anastomosis in humans. This report aimed to describe the use of Van Velthoven suture after excisional prostatectomy in a canine, which suffered partial loss and deformation of the urinary bladder after complications of perineal hernia.Case: A thirteen-year-old male dog presented dyschezia, hypophagia and had increased water ingestion; furthermore, owner verifi ed a swelling lateral to the anus. On clinical examination it was observed left perineal hernia with incarcerated content, and peritonitis was diagnosed by ultrasonography exam. Antimicrobial and fl uid therapy were initiated, and one day after the patient was referred to surgery. Through perineal access was observed retrofl exed urinary bladder partially necrotic and multiple prostatic cysts; due to great extent of the necrotic urinary bladder, associated with impossibility of complete necrotic bladder tissue removal, prostate and urinary vesicle were placed in the peritoneal cavity. It was proceeded hernia reconstruction using polypropylene mesh and monofi lament nylon suture. Through median celiotomy, the bladder necrotic tissue was removed; due to hemodynamic patient instability, the total prostatectomy that was initiated was postponed, pe

Background: Prostatectomy excision is indicated for patients with neoplasm, trauma or recurrent prostatic abscess; Van Velthoven suture have been used in urethrovesical laparoscopic anastomosis in humans. This report aimed to describe the use of Van Velthoven suture after excisional prostatectomy in a canine, which suffered partial loss and deformation of the urinary bladder after complications of perineal hernia.Case: A thirteen-year-old male dog presented dyschezia, hypophagia and had increased water ingestion; furthermore, owner verifi ed a swelling lateral to the anus. On clinical examination it was observed left perineal hernia with incarcerated content, and peritonitis was diagnosed by ultrasonography exam. Antimicrobial and fl uid therapy were initiated, and one day after the patient was referred to surgery. Through perineal access was observed retrofl exed urinary bladder partially necrotic and multiple prostatic cysts; due to great extent of the necrotic urinary bladder, associated with impossibility of complete necrotic bladder tissue removal, prostate and urinary vesicle were placed in the peritoneal cavity. It was proceeded hernia reconstruction using polypropylene mesh and monofi lament nylon suture. Through median celiotomy, the bladder necrotic tissue was removed; due to hemodynamic patient instability, the total prostatectomy that was initiated was postponed, pe