Urethrostomy +/- partial phallectomy in Cows (Bovis) | Vetlexicon
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Urethrostomy +/- partial phallectomy

ISSN 2398-2993

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Synonym(s): Penectomy

Introduction

  • Salvage surgical procedure for male animals experiencing urolithiasis Urolithiasis with urethral obstruction.
  • There are two locations that have been described:
    1. “Low” perineal urethrostomy (near the scrotum).
    2. “High” perineal urethrostomy (near the ischium).

Uses

Advantages

  • Short-term, the procedure can allow the animal to recover for salvage slaughter.
  • May allow the animal to have semen collected for future breeding options.

Disadvantages

  • It is an invasive surgical procedure.
  • Long-term outcome is considered to be poor.
  • Loss of natural breeding ability.
  • There is a risk that stricture can develop (weeks to months post procedure).
  • Affected animals can obstruct proximal to the stoma.
  • Repeat procedures may be required for some animals.

Technical problems

  • Identification of the urethra.  
  • The size of the animal.
  • Determining the location of the urethral obstruction.
  • Visualization of the structures can be difficult due to urine accumulating subcutaneously in urethral rupture cases .

Alternative techniques

  • Tube cystotomy.
  • Percutaneous tube cystotomy.
  • Cystotomy combined with normograde and retrograde urethral flushing.
  • Laser lithotripsy.
  • Perineal urethrotomy.
  • Penile amputation (phallectomy/penectomy) Phallectomy.

Time required

Preparation

  • Heavy intravenous sedation and anesthesia, time to take effect: 5-10 min Sedating cattle Anesthetizing cattle.
  • Heavy intramuscular sedation and anesthesia, time to take effect: 15-30 min.
  • Epidural anesthesia Epidural: 5 min.
  • Aseptic preparation: 5 min.

Procedure

  • This will be dependent on surgeon experience and the surgical approach used.
  • The author would typically allow 60 min.

Decision taking

Criteria for choosing test

  • Medical therapy has not achieved a clinical resolution.
  • The desired outcome for the affected animal:
    • Kept as a pet (either technique is appropriate).
    • Salvage procedure for a breeding animal (“High” perineal urethrostomy - near the ischium is most appropriate).
    • Finished for slaughter (either technique is appropriate).

Risk assessment

  • Welfare of the animal.
  • The overall hydration status.
  • The overall electrolyte abnormalities.
  • The overall acid-base status.
  • The overall metabolic state.
  • Renal function.
  • The duration of urethral obstruction.
  • The presence of concurrent bladder rupture.
  • Location of the urolith.
  • Whether the urethra has ruptured.
  • The health of the urethral tissue at the proposed surgical site.

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.
  • Sultan B et al (2017) Bovine urethral obstruction and its treatment: a review. Int J Curr Res Biol Med 2 (7), 15-25.
  • Ismail Z B (2016) Epidural analgesia in cattle, buffalo, and camels. Vet World (12), 1450 PubMed.
  • Videla R & van Amstel S (2016) Urolithiasis. Vet Clin North Am Food Anim Pract 32 (3), 687–700 PubMed.
  • Edwolt J, Jones M & Meisner M (2008) Surgery of obstructive urolithiasis in ruminants. Vet Clin North Am Food Anim Pract 23 (3), 455-465 PubMed.

Other sources of information

  • Parkinson T J, Vermunt J J & Malmo J (2019) Diseases of Cattle in Australasia: A Comprehensive Textbook. New Zealand Veterinary Association Foundation for Continuing Education, New Zealand. pp 1140-1141.
  • Ames, N K (2014) Noordsy’s Food Animal Surgery – chapter 16. Wiley & Sons. pp 221-231.
  • Fubini S L & Ducharme N (2004) Farm Animal Surgery. Elsevier Health Sciences, USA. pp 539-540.