Uretrostomia prepucial em cães por acesso pré-escrotal: uma nova abordagem

Abstract

RODRIGUES, G. M. Preputial urethrostomy in dogs by prescrotal access: a new approach. 2022. 52p. Dissertation (Veterinarian) – School of Veterinary Medicine and Animal Science – Federal University of Bahia, 2022. Complications reported in urethrostomies in dogs are relevant, resulting in expensive post surgical treatments that may lead to the need for surgical revisions. Part of these complications can be reduced by incorporating the internal lamina of the foreskin as a site of urethral anastomosis, as described in studies on the preputial urethrostomy technique. However, the approaches described in this technique present a median incision to the foreskin for surgical access, which denotes more significant trauma. Thus, the objective was to propose a new approach to preputial urethrostomy through prescrotal access to attenuate the surgical trauma and to describe in detail the necessary surgical maneuvers and evaluate their feasibility. The surgical technique was revised, modified, and standardized initially in cadavers and later used in 10 dogs in the hospital routine with lesions to the penile urethra, penis and foreskin. After accessing the urethral lumen through a prescrotal incision, the body of the penis was sectioned, and the glans were removed utilizing circumferential divulsion, exposing the internal preputial lamina used in the urethral anastomosis. Surgical maneuvers were considered medium complexity, feasible and adequate to restore urinary flow. In the postoperative follow-up, it was possible to verify that the animals presented sui generis urination, in a jet, with the maintenance of the external preputial aesthetic aspect. In addition to the cutaneous ecchymosis inherent to the surgical trauma, the relevant complications were related to anastomotic dehiscence and consequent leakage of urine into the subcutaneous tissue. The dehiscence resulted from space restriction failure, and its consequences were solved by re-approaching with the same technique. The results allowed us to infer that the proposed access to the prescrotal site favored the preputial urethrostomy technique since the surgical trauma was minimized and the urinary flow was reestablished, in addition to providing a favourable esthetic conformation.