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Uterine prolapse: technique
Synonym(s): womb, replace, reduction, repair
Introduction
- Techniques for replacement of a uterine prolapse can have many minor variations, however they are all broadly similar and have the same goal. That is: replacement of the large everted organ back into its correct anatomical position within the abdomen as quickly and gently as possible.
Uses
Advantages
- Simple.
- Effective.
Disadvantages
- Manually intensive.
- Emergency situation.
Technical problems
- Lack of physical help can be an issue.
- Some veterinary surgeons have advocated the use of a hoist to raise the rear-end of a cow with leg straps and a tractor, so that gravity aids replacement. This technique has previously been advocated if the uterus cannot be replaced manually with the cow standing or in a frog-legged recumbent position.
- The authors’ and the editor would discourage the use of this technique due to the negative cattle welfare implications of such a procedure.
Time required
Preparation
- 15 minutes.
Procedure
- This can vary. Anything from 5 minutes to an hour can be expected, depending on technique, position of the animal, duration of prolapse and multiple other factors.
Decision taking
Criteria for choosing test
- The prolapsed uterus and the patient must be inspected for viability before any attempt to replace it is made .
- Assessment for the presence of any entrapped viscera should be made, with the bladder being most common.
- Full thickness lacerations should be sutured with absorbable suture material before replacement begins.
- Rarely, uterine amputation is carried out as a salvage procedure.
Risk assessment
- Ensure that the animal is well restrained before attempting replacement.
Requirements
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Preparation
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Technique
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Aftercare
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Outcomes
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Further Reading
Publications
Refereed Papers
- Recent references from PubMed and VetMedResource.
- Wapenaar W, Griffiths H, Lowes J & Brennan M (2011) Incidence of some diseases in connection with parturition in dairy cows. Acta Veterinaria Scandinavica 19, 341-353 PubMed.
- Murphy A M & Dobson H (2002) Predisposition, subsequent fertility, and mortality of cows with uterine prolapse. Vet Rec 151, 733-735 PubMed.
- Correa M T, Erb H N & Scarlett J M (1992) A nested case-control study of uterine prolapse. Theriogenology 37, 939-945 VetMedResource.
- Gardner I A, Reynolds J P, Risco C A & Hird D W (1990) Patterns of uterine prolapse in dairy cows and prognosis after treatment. JAVMA 197, 1021-1024 PubMed.
- Jubb T F, Malmo J, Brightling P & Davies G M (1990) Survival and fertility after uterine prolapse in dairy cows. Aust Vet J 67, 22-24 PubMed.
- Plenderleith B (1986) Prolapse of the uterus in the cow. In Practice 8, 14-15.
- Risco C A, Reynolds J P & Hird D (1984) Uterine prolapse and hypocalcaemia in dairy cows. JAVMA 185, 1517-1519 PubMed.
- Roine K & Saloniemi H (1978) Incidence of some diseases in connection with parturition in dairy cows. Acta Veterinaria Scandinavica 19, 341-353 PubMed.
- Odegaard S A (1977) Uterine prolapse in dairy cows. A clinical study with special reference to incidence, recovery and subsequent fertility. Acta Veterinaria Scandinavica 63, 1-124 PubMed.
Other sources of information
- Noakes D (2009) Arthur’s Veterinary Reproduction and Obstetrics. 9th edn. Saunders Elsevier.
- Potter T (2008) Prolapse of the Uterus in the Cow. UK Vet J 13, 1-3.
- White A (2007) Uterine Prolapse in the Cow. UK Vet 12, 21-23.