STUDIES ON THE URETHRAL HEALING USING BIOCASINGS WITH AND WITHOUT URETHROSTOMY IN DOGS
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Date
1999-07
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SRI VENKATESWARA VETERINARY UNIVERSITY TIRUPATI - 517 502. (A.P.) INDIA
Abstract
ABSTRACT:
Ninety six mongrel dogs were randomly divided into 2 groups of
48 animals of urethrotomy and urzthrostomy. Each group was further
divided into four sub groups depending on the technique ci
reconstruction. -4111 cm incision was created on urethra prescrotally in dl
the animals. The urethral incision was left unsutured/ sutured to carp==
cavernosum penis in control animals keeping catheter in situ. Gelatm
fibrin and amnion were wrapped around the urethrotomy / urethrostomy
sites. The urethral healing was evaluated by clinical, haematologicd
biochemical, radiological, gross and histopathological studies.
Ventral urethral incision caudal to ospenis was found to be u
effective model for the evaluation of biocasings for urethral healing.
Introduction of catheter pre-operatively and lateral retraction of retracror
penis muscle helped in location of urethra and application of biocasings
on to operated site; Suturing of muscles and the biocasings helped in
securing the casings in positiod at the urethral incision. Processed
gelatin, fibrin and amnion provided adequate strength to wrap around
the operated site; Premedication of the dogs before injection of
thiopentone sochum facilitated easy intravenous injection of anaesthetic
with minimal restraint and potentiated the effect. Intermittent doses of
thiopentone sodium produced adequate anaesthesia and muscle relaxation
to perform surgery.
Haemorrhage from the operative site was less in urethrostomy
group when compared to urethrotomy group. Act of micturition was
painful in the initial post operative days in all the dogs. Scrota1 oedema
and subcutaneous ecchymosis were not a common observation.
The rectal temperature, pulse and respiratory values showed
significant increase during initial post-operative days in all dogs.
Significant variation was noticed among the control sub groups and
gelatin, amnion and fibrin in both the groups. Urine analysis revealed
non-significant variation in pH value and specific gravity in both the
groups.
Non-significant variation in blood urea nitrogen levels were
observed among control ; gelatin, fibrin, and amnion treated animals of
both groups. A significant increase in serum creatinine values were
observed in all the dogs. Inorganic phosphorus values showed an initial
raise. A sigruficant decrease was noticed in total protein values of control
and treated groups, which was more in control and gelatin treated
animals.
Total erythrocyte values, packed cell volume and haemoglobin
values exhibited sigmficant decrease upto 5th post-operative day and 3rd
post-operative day in urethrotomy and urethrostomy groups respectively.
Erythrocyte sedimentation rate showed hghly significant increase upto
seventh post operative day in gelatin group only. Total leucocyte counts
were elevated significantly upto 5th post operative day in urethrotomy
group and upto 7th post-operative day In urethrostomy group.
Positive contrast urethrography using 15% barium sulphate
provided good visualisation ofY urethra. Early urethrograms of
urethrotomy group showed no leakage at the operative site; whereas
urethrostomy group showed potential leakage of contrast media into
periurethral space. In the later stages, control and gelatin wrapped
urethra showed mucosal irregularities and stricture formation. The fibrin
and amnion wrapped animals showed patent urethral lumen in
urethrotomy group. The control and gelatin treated animals of
urethrostomy group showed fistulation and mucosal irregularities, while
fibrin and gelatin treated animals showed widening of the urethral
lumen at the operative site.
Grossly, all the dogs showed swelling, congestion, and edema at
the operative site in early post operative days. As time advanced, these
changes were not seen. Thick to filamentous adhesions at the operated
site with the surrounding tissues were seen in all the dogs.
Microscopically all the sections showed inflammatory reaction in the
early post-operative days. The inflammatory reaction was severe in
control and gelatin wrapped animals compared to fibrin and amnion
treated group animals. Urethrotomy group showed stenosis of urethral
lumen whereas urethrostomy group showed widening of urethral lumen
at operated site. EpitheliaLization was complete by 14 to 30 days in both
the groups.
Based on the above observations made it is concluded that
urethrotomy incision covered with fibrin and amnion proved to be better
compared to control and gelatin treated groups. Urethrostomy groups had
post-operative complications like leakage, fistula formation, and mucosal
abnormalities. However these complications can be lessened by use of
fibrin and amnion as evidenced by the result of the present study.
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