Muhammed Kürşad BİRDANE, Duygu BAKİ ACAR

Urinary bladder retroflexion and dystocia in a bitch with the vaginal supportive connective tissue failure

Bu olguda, 2,5 yaşında ve 35 kg ağırlığında melez ırk bir köpekte rastlanan güç doğum şikayeti ile birlikte vulvada büyük bir kitle olgusu sunuldu. Alınan anamnezde, 1,5 yıl önce köpeğe tip III prolapsus vagina nedeniyle submukozal rezeksiyon operasyonu uygulandığı öğrenildi. Kliniğimizde yapılan transabdominal ultrasonografik muayenede uterusta birkaç adet canlı fetüs saptanırken, idrar kesesi abdomen içinde gözlenemedi. Vulvadan dışarı çıkan kitleye yapılan ultrasonografi muayenesinde anekojenik yapıda, içi sıvı dolu idrar kesesi görüldü. Fetüsler sezaryen operasyonu ile alındı. Operasyon sırasında, korpus uteri ve bir adet canlı fetüs ile birlikte idrar kesesinin vagina duvarı içinde sınırlı olduğu saptandı. Korpus uteri ve idrar kesesi dikkatle abdominal boşluk içine alınarak fetüs çıkarıldı, ardından ovaryohisterektomi gerçekleştirildi. Bu olguya oldukça nadir rastlansa da, idrar kesesinin retrofleksiyonu pelvis tabanını destekleyen konnektif dokudaki yetersizliğe ve doğum sırasında aşırı ıkınmalara bağlı olarak şekillenebilmektedir. Bu nedenle, idrar kesesindeki basıncın azaltılması ve kitle içinde olabilecek fetüsün kurtarılabilmesi amacıyla olguya hızla müdahale edilmesi gerekmektedir.

Bir köpekte vajinanın konnektif dokusunun yetersizliği ve güç doğum ile birlikte seyreden idrar kesesi retrofleksiyonu olgusu

This article describes a 2.5 years old cross breed bitch, weighing 35 kg, with dystocia and a large mass protruding through the vulva. A surgical resection of a type III vaginal prolapse had been performed 1.5 years previously. On admission, transabdominal ultrasonography revealed several live foetuses in the uterine horns, but the urinary bladder was not visible in the abdomen. An anechogenic, fluid-filled bladder was observed during ultrasonography of the protruded mass. Foetuses were removed by caesarean section. During the surgery, it was realized that the uterine body and a live foetus were confined within the vagina as well as the bladder. The foetus was removed by repositioning the corpus uteri and bladder gently, and ovariohysterectomy was performed. Although the situation is exceptional, urinary bladder retroflexion could occur due to the failure of supportive connective tissue of pelvic floor and extreme straining during parturition. Therefore, retroflexion should be managed as an emergency to reduce the pressure in the bladder and to rescue the foetus if it is in the protruded tissue into the vagina.

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