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Urethrostomy +/- partial phallectomy
Synonym(s): Penectomy
Introduction
- Salvage surgical procedure for male animals experiencing urolithiasis Urolithiasis with urethral obstruction.
- There are two locations that have been described:
- “Low” perineal urethrostomy (near the scrotum).
- “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 9 (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.