Elléshez társult húgyhólyag-előesés sebészi megoldása kancában - Esetismertetés

Abstract

SUMMARY Background: Urinary bladder eversion rarely occurs in mares and is usually a consequence of increased abdominal pressure and excessive straining during parturition or early postpartum period. The relatively large diameter and short length of the mare’s urethra permits partial or complete eversion of the bladder into the vagina.Objectives: The aim of this case report is to describe the surgical treatment of postpartum true prolapse with eversion of the urinary bladder in a mare.Materials and Methods: A 13 year-old Hungarian Warmblood mare was referred as an emergency case to the Equine Clinic of the University of Veterinary Medicine. The mare had dystocia at the day of presentation and arrived with a complaint of bladder eversion through the urethra. After clinical examination an acute eversion and prolapse of the urinary bladder with mucosal injury was diag-nosed. Reduction of the excessive oedema and thickening of the bladder’s wall was unsuccessful, therefore the manual reposition of the bladder was impossi-ble. After sedation combined with epidural anaesthesia, a 5 cm longitudinal inci-sion was made on the ventral wall of the vagina to widen the urethral sphincter and through this aperture the complete reversion of the bladder was managed and the wound was closed with simple continuous suture pattern.Results and Discussion: After 5 days of hospitalisation the mare recovered uneventfully, showed no signs of pain or difficulties during urination. In this case nothing but the surgical procedure to widen the urethral aperture in the vagina was the ultimate successful treatment to save the mare. During the 20 months follow up period the mare did not show any complication, neither urinary disor-der nor incontinence. The present case was the second bladder prolapse treated at the clinic within the last 18 years, which confirms that the condition is very rare but can occur after parturition.