Use of a rectus abdominis muscle flap to repair urinary bladder and urethral defects in a dog

Roman S. Savicky Michigan Veterinary Specialists, 29080 Inkster Rd, Southfield, MI 48034.

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Andrew H. Jackson Michigan Veterinary Specialists, 29080 Inkster Rd, Southfield, MI 48034.

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 DVM, DACVS

Abstract

Case Description—An 11-month-old female dog was evaluated because of a 3- to 4-day history of stranguria and hematuria.

Clinical Findings—Rectal and vaginal examination and abdominal radiography revealed a large (4 × 2 cm), firm, ovoid object in the area of the pelvic inlet, between the vagina and colon.

Treatment and Outcome—Surgical exploration revealed an abscess and moderate amount of seropurulent fluid in the left caudal abdominal quadrant. A large urethrolith (3.7 × 2.0 × 1.5 cm) was evident in the proximal portion of the urethra. The urethrolith was associated with a 3 × 1-cm area of necrosis in the ventral aspect of the proximal portion of the urethra and a 3 × 3-cm area of necrosis in the area of the bladder trigone. The necrotic areas were débrided, and the defect was repaired with an axial pattern flap constructed from the rectus abdominis muscle. During a follow-up examination 2.5 years after surgery, the dog was clinically normal with no history of urinary incontinence. During rigid cystoscopy, the ure-thral mucosa appeared grossly normal, and there was no evidence of stricture.

Clinical Relevance—Findings suggested that axial pattern flaps constructed from the rectus abdominis muscle flap may be useful in reconstructing large urinary bladder and urethral defects.

Abstract

Case Description—An 11-month-old female dog was evaluated because of a 3- to 4-day history of stranguria and hematuria.

Clinical Findings—Rectal and vaginal examination and abdominal radiography revealed a large (4 × 2 cm), firm, ovoid object in the area of the pelvic inlet, between the vagina and colon.

Treatment and Outcome—Surgical exploration revealed an abscess and moderate amount of seropurulent fluid in the left caudal abdominal quadrant. A large urethrolith (3.7 × 2.0 × 1.5 cm) was evident in the proximal portion of the urethra. The urethrolith was associated with a 3 × 1-cm area of necrosis in the ventral aspect of the proximal portion of the urethra and a 3 × 3-cm area of necrosis in the area of the bladder trigone. The necrotic areas were débrided, and the defect was repaired with an axial pattern flap constructed from the rectus abdominis muscle. During a follow-up examination 2.5 years after surgery, the dog was clinically normal with no history of urinary incontinence. During rigid cystoscopy, the ure-thral mucosa appeared grossly normal, and there was no evidence of stricture.

Clinical Relevance—Findings suggested that axial pattern flaps constructed from the rectus abdominis muscle flap may be useful in reconstructing large urinary bladder and urethral defects.

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