The Study On Canine Urinary Tract Reconstruction By Bladder-preputial Anastomosis

Urethral defect is serious, long urethral injury, is one of the commonly-occurringdiseases of male dogs, caused by urolithiasis, malignancy, trauma et al. Presently, the maintreatment could be used is urethrostomy. However, the existing urethrostomies cann`t treatthe pelvic urethral defect. Except the pelvic urethral defect, after performed urethrostomy,many complications also could be caused, such as pyogenic infection, urethrostomygranuloma, dermatitis with urine erosion in the anastomotic orifices, anastomotic suppurativeinfection, and proliferative granuloma blocking artificial permanent urethra stoma caused bylong-term infection, etc. In addition, there`s not a treatment could be used as remedialmeasures if perineal urethrostomy, pelvic urethrostomy and re-pubic urethrostomy failed. Inthis paper, on the basis of screening the surgery pathway, we study the feasibility and theeffect of canine urinary tract reconstruction by bladder-preputial anastomosis, laying afoundation for solving the diseases in the pet clinical.1. The bladder-preputial anastomosis pathway selection.4dogs were randomlydivided into two groups,2of each group, and performed prepuce incision pathway andprepuce-side incision pathway, respectively. Observing the postoperatively effects, andcompared to each other, screening the optimal pathway. We chose the surgical pathway withthe principles of easy to operate, operative field exposed enoughly, gently tissue damage,less postoperatively complications.Results: Prepuce incision pathway.2dogs lived well, and their drink, appetite andmental state were normal, postoperatively. Urine could outflow through the anastomoticastium and urination normally. Postoperatively day30, dogs were performed urethral-bladder retrograde urethrography and autopsy, and we seen that the anastomotic astium wereunobstructed. Bladder serosa and peritoneum, bladder mucosa and preputial mucosal healed(combine) completely, smoothly, and no fistula.Prepuce-side incision pathway.1dog lived well, and it`s drink, appetite and mentalstate were normal, postoperatively. But the anastomotic astium emitted fetid odor, Urine couldn`t outflow through the anastomotic astium. Postoperatively day30, dogs wereperformed urethral-bladder retrograde urethrography and autopsy, and we seen that theanastomotic astium were stricture, had leakage around it. Bladder serosa and peritoneumhealed (combination) completely, smoothly, but had a fistula on the bladder-preputialanastomotic stoma and had stench effusion. Another1dog was accidie, and died day3,postoperatively. Autopsy findings, the operative site anastomotic stoma. was shallow black.has subcutaneous effusion and the tissue was jelly.In all, we chose the prepuce incision pathway as the follow-up experimental studysurgery pathway.2. Canine urinary tract reconstruction by bladder-preputial anastomosis.16dogswere randomly divided into two groups (intact and castration),8of each group, performedbladder-preputial anastomosis. Evaluated the surgery by observing the dogs`urine excretion,postoperative recovery, bladder-urethral retrograde urethrography, autopsy and biopsy aftereuthanasia.Results: the16dogs all could excrete urine through the anastomotic stoma,postoperatively. Postoperatively day1,15dogs`drink and appetite returned to normal.Postoperatively day2, the other one dog`s drink and appetite returned to normal.Postoperatively day30,60,90, the dogs were performed urethral-bladder retrogradeurethrography.16dogs had no obvious abnormalities, the anastomotic stomas wereunobstructed. Postoperatively day90, performed gross and histological observations tobladder-prepuce anastomotic orifices after euthanasia,14dogs`bladder and abdominal wall,bladder mucosa and preputial mucosa healed (combine) completely, they were smooth anddidn`t have fistula. But, one dog`s anastomotic orifices had a little protuberance, the otherone had a small fistula at the site of anastomosed, but no effusion and infection occurred.Histological observation of the bladder-prepuce anastomotic orifices showed that thebladder mucosa and prepuce mucosa cells had mixed togetherConclusion: Prepuce incision pathway bladder-preputial anastomosis could rebuild theurinary tract. It provided a new method for pelvic urethral defect treatment, also could beused as remedial treatment after the perineal urethrostomy, pelvic urethrostomy and re-pubicurethrostomy failed.